We thank Drs Wolthuis and D'Hoore for their letter. Before December 2007, our department generally managed women with rectal endomet-riosis by performing segmental rectal resections, whereas we now perform three times more nodule excisions than resections, accompanied by a systematic recommendation of post-operative continuous contraceptive pill intake.This choice is based on strong arguments: surgical morbidity appears to be higher in women managed by colorectal resection (Darai et al., 2005; Mereu et a/., 2007; Slack et a/., 2007), postoperative functional digestive symptoms are expected to be less satisfactory after rectal removal (Ret Davalos et a/., 2007; Roman et a/., 2010) and rectal resection does not prevent post-operative recurrences of pain (Vercellini et al., 2009).First, we agree with the author's comments on the learning curve and the risks connected with this new procedure and that it should be carried out by surgeons specialized in colorectal surgery and trained with the use of this stapling device.
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