Quality of life assessment after bowel resection performed for deep infiltrating colorectal endometriosis
Dobó Noémi
Surgical Medicine Division
Dr. Szijártó Attila
SE, Szülészeti és Nőgyógyászati Klinika, Baross utcai részleg tanterme
2026-02-17 09:00:00
Reproductive medicine
Dr. Rigó János
Dr. Bokor Attila
Dr. Skaliczki Gábor
Dr. Lampé Rudolf
Dr. Patócs Attila
Dr. Lintner Balázs Zoltán
Dr. Kovács Kálmán
The conventional laparoscopic approach for the surgical management of deep endometriosis (DE) infiltrating the rectum ensures improved digestive functional outcomes and quality of life. The natural orifice specimen extraction (NOSE) technique for treating colorectal DE can significantly accelerate postoperative recovery, reduce the duration of hospital stay, and result in less postoperative pain and fewer complications (133). However, short- and mid-term solid data on gastrointestinal function following conventional laparoscopic segmental bowel resection (CLR) compared with NOSE-colectomy (NC) for DE are sparse (133). There is increasing evidence that intermediate and long-term bowel dysfunction may arise as a result of radical surgery for deep endometriosis (DE) of the rectum. Numerous studies have indicated that functional outcomes may be more favorable with conservative surgical approaches, specifically, the excision of endometriotic tissue while preserving the luminal structure of the rectal wall, compared to traditional segmental resection techniques for DE, particularly when performed for low DE (79).
Our randomized, open-label, two-arm, parallel-group controlled trial indicates that no significant differences were observed in the NC and CLR groups' postoperative LARS scores, VAS, EHP30, and GIQLI. LARS scores did not reveal significant differences 12 months postoperatively compared to the preoperative values in both groups. GIQLI scores, pain symptoms, and quality of life scores improved significantly 12 months after the operation compared with baseline values in the CLR and NC groups (133).
We found no statistically significant difference between the incidence of LARS (31.7% and 37.9%, respectively) among patients operated by LTADE when compared with NVSSR (P = 0.4). A higher rate of severe complications was observed in women undergoing LTADE (19.7%) when compared with patients with NVSSR (9.0%, P = 0.029) (79). According to our results, NC is a feasible, effective, and safe surgical approach for treating patients with rectal DE. Our study did not show a statistically significant difference between CLR and NC techniques in mid-term digestive and pain outcomes (133). The incidence of low anterior resection syndrome does not appear to be higher following nerve- and vessel-sparing segmental resection compared to more conservative surgical approaches, such as laparoscopic transanal disc excision, in patients undergoing rectal surgery for low deep infiltrating endometriosis.
