Segmentary rectal resection and rectal shaving by laparoscopy for endometriosis: Peri-operative morbidity

Objective. - A comparative study of the pen-operative complications between two surgical methods used in the treatment of bowel endometriosis: shaving versus segmentary colorectal resection. Patients and methods: - Forty-one patients, who were treated by laparoscopic treatment of bowel endometriosis between January, 2010 and November, 2011 were included in a retrospective, unicenter series. Twenty patients had a "shaving" while 21 had a segmentary rectal resection. Results. - The average follow-up was of 13.6 +/- 6.7 months. No recurrence was observed during the study. The duration of surgery and the length of stay were significantly longer in the resection group, respectively 485.5 +/- 85 min and 9.6 +/- 6.5 days against 259.3 +/- 104 min and 4 +/- 1.3 days in the shaving group. The rates of early and late complications (Dindo classification) were respectively 71.4% and 33.3% in the resection group against 20% and 0% in the shaving group (P < 0.05). Our rate of vaginal fistula was null; this is to put in connection with the fact that an ileostomy of discharge was realized in 95.2% of the resections, as well as an epiplooplasty, when it was technically possible, in the case of a concomitant vaginal opening. Discussion and conclusion. - The pen-operative morbidity was higher after partial bowel resection. Our study underlines that these two techniques are probably not addressed to the same patients. Considering the significant morbidity, it would be interesting to define in a consensual way, who the surgery should be propose to and by which procedure. (C) 2013 Elsevier Masson SAS. All rights reserved.