Limited segmental anterior rectal resection for the treatment of rectovaginal endometriosis: pain and complications

摘要

The aim of this cohort study was to assess the long-term response, complications and quality of life in patients undergoing segmental anterior rectal resection for endometriosis. The subjects consisted of patients who have undergone a segmental anterior rectal resection for endometriosis in the setting of a tertiary referral unit for the management of severe endometriosis. The data were obtained by means of a case note review and patient questionnaire. The main outcome measures were surgical complications and overall subjective improvement. Dysmenorrhoea, dyspareunia, dyschezia and chronic daily pain were measured using a visual analogue scale. Twenty-one anterior resections were performed by laparotomy and 24 by laparoscopy. There was no complication in 64% of the cases, and 83% of patients felt that their pain had resolved completely or was greatly improved. The Mean Self-Rated Health Status was significantly lower in the study group than in the general population. Deeply infiltrating endometriosis was confirmed in 92% of rectal specimens. Based on these results, we conclude that segmental anterior rectal resection is a relatively safe procedure for very severe rectovaginal endometriosis and also a very effective treatment.