Surgery-related complications and long-term functional morbidity after segmental colo-rectal resection for deep infiltrating endometriosis (ENDO-RESECT morb)

Anna Fagotti, Francesco Fanfani, Maria Gabriella Ferrandina, Franco Scaldaferri, Giovanni Scambia, Nicola Nicolotti, Luigi Carlo Turco, Attilio Tuscano, Marco Antonio Palumbo, Stefano Uccella, Francesco Cosentino

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Purpose: Segmental resection has been generally associated with increased peri-operative risk of major complications. While major complications are widely acknowledged, minor complications, such as slight, to moderate infections, peripheral sensory disturbances, bladder voiding dysfunction, postoperative urinary obstruction, and sexual disorders are less reported. The aim of this study is to investigate the surgery-related complications and functional disorders, as well as to evaluate their persistence after long-term follow-up in women undergone segmental resection for deep infiltrating endometriosis. Special attention is given to evaluating impairments of bowel, bladder, and sexual function. Methods: All clinical data obtained from medical records of women who underwent segmental resection for intestinal endometriosis between October 2005, and November 2017, in Catholic University Institutions. Perioperative morbidity was classified by Extended Clavien–Dindo classification. Postoperative intestinal, voiding, and sexual morbidity was estimated by the compilation of specific questionnaires. Results: Fifty women were included in the study. Forty-three high colorectal resections (86%), 6 low resections (12%), and 1 ultra-low resection (2%) were performed, while in 3 cases (6%) multiple resections were needed. The overall complication rate was 44%. Nineteen women (38%) experienced early complications and 3 women (6%) late complications. Long-term functional postoperative complications were composed of intestinal in 30%, urinary in 50%, and sexual in 64% of the study population. Median follow-up was 55.5 months. Conclusions: Segmental resection, when indicated, offers a radical and feasible approach for bowel deep infiltrating endometriosis, resulting in an improved general quality of life. The bowel and bladder complications appear to be acceptable and often reversible. Postoperative sexual dysfunctions, such as anorgasmia and insufficient vaginal lubrication, appear to persist over time. Surgeons and women have to be aware of the incidence of this kind of complications.
Lingua originaleEnglish
pagine (da-a)983-993
Numero di pagine11
RivistaArchives of Gynecology and Obstetrics
Volume302
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Deep infiltrating endometriosis
  • Intestinal disorders
  • Voiding disorders
  • Segmental resection
  • Sexual dysfunction
  • Personalized medicine

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