Surgical management by disk excision or rectal resection of
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The possibility of normal bowel movements is higher after disk excision versus low rectal resection in women with deep endometriosis infiltrating the low rectum.

The objective of this study was to assess the risk of low anterior resection syndrome (LARS) between women managed by either disk excision or rectal resection for low rectal endometriosis.

172 patients managed by disk excision or rectal resection, for deep endometriosis infiltrating the rectum less than 7 cm from the anal verge were enrolled in this retrospective study.108 patients were treated by disk excision (group D) and 64 by rectal resection (group R). All patients answered the LARS score questionnaire.

--Follow-up was 33.3+/-22 months for group D and 37.3 +/-22.1 months for group R.

--The rates of rectovaginal fistula and pelvis abscess requiring radiological drainage and surgery in the D and R groups were respectively 7.4% and 8.3% vs. 7.8% and 9.3%.

--The rate of women with normal bowel movements postoperatively was higher in group D.

--Women enrolled in group R reported a higher frequency of stools, clustering of stools, and fecal urgency.

--Regression logistic model revealed two independent risk factors for minor/major LARS: performing low rectal resection and presenting with bladder atony requiring self-catheterization beyond postoperative day 7.

In particular, the probability of normal bowel movements is higher following disk excision versus low rectal resection in women with deep endometriosis infiltrating the low rectum.

The Journal of Minimally Invasive Gynecology
Source: https://doi.org/10.1016/j.jmig.2021.05.007
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