Rectal disc resection improves stool frequency in patients with deep infiltrating endometriosis: A prospective study

• Published in: Australian & New Zealand journal of obstetrics & gynaecology Vol. 60; no. 3; pp. 454 - 458
• Main Authors: Ip, Julian C. Y., Chua, Terence C., Wong, Shing W., Krishnan, Surya
• Format: Journal Article
• Language: English
• Published: Australia 01-06-2020
• Subjects: Adult; Aged; Cohort Studies; deep infiltrating endometriosis; Defecation; endometriosis; Endometriosis - surgery; Female; Humans; Laparoscopy; Middle Aged; Prospective Studies; Rectal Diseases - surgery; rectum; Rectum - physiopathology; Rectum - surgery; surgery; Surveys and Questionnaires; Treatment Outcome; Young Adult; endometriosis; rectum; deep infiltrating endometriosis; surgery
• ISSN: 0004-8666; 1479-828X
• DOI: 10.1111/ajo.13145

Background
Gastrointestinal symptoms occur with deeply infiltrating endometriosis (DIE) of the rectum.
Aims
To explore the medium‐term gastrointestinal functional outcomes after rectal disc resection for endometriosis.
Methods
All women undergoing laparoscopy for stage IV endometriosis at a tertiary referral hospital between November 2016 and January 2018 and had evidence of DIE of the rectum were included. Low anterior resection syndrome (LARS) score was measured using a validated questionnaire.
Results
Thirty‐six women formed the cohort of the study. The mean age was 37 years (range 20–72 years). All women underwent a laparoscopic anterior rectal disc resection for DIE. The response rate was 100%. There was an increase in the percentage of patients having no LARS postoperatively compared to preoperatively (an increase of 78–83%). There was a reduction in LARS scores postoperatively observed in 18 patients (50%) and the prevalence of major LARS decreased postoperatively from 10% to 1%. Comparison of individual symptoms revealed a significant improvement in postoperative stool frequency scores (P = 0.02). Multivariate analysis using logistic regression analysis demonstrated that reduction in postoperative stool frequency scores remained an independent factor (P = 0.008).
Conclusion
Rectal disc resection is feasible and safe, achieving observable improvements in stool frequency in patients with rectal DIE.