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

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.