Rectal Endometriosis Research Paper Summary

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Fact Friday 30th July 2021

Summary of Article: Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum. Horace Roman, M.D., Ph.D.,a,b Maud Vassilieff, M.D.,a Jean Jacques Tuech, M.D., Ph.D.,c Emmanuel Huet, M.D.,c Guillaume Savoye, M.D., Ph.D.,d Loïc Marpeau, M.D.,a and Lucian Puscasiu, M.D., Ph.D.e

Rectal endometriosis surgery is a topic that is of increasing interest in the area of genealogical surgery. Studies show that there are two surgical philosophies or approaches: 1. The radical philosophy – based on colorectal resection (removing a section of bowel and rejoining the parts). 2. The conservative philosophy – prioritises conservation of the rectum. This could involve shaving the outside of the bowel or removing a disc of bowel from the surface. The aim of this study was to compare the digestive effects colorectal surgery had on people with endometriosis. The study looked at surgeries that used both philosophies. There were 75 patients in this study; they had their rectal endometriosis diagnosed via MRI and ultrasound as well as other preoperative assessments. Following the surgery, most of the patients were receiving hormone treatment; patients who were trying to conceive did not have this treatment. The patients were split into two groups. The groups had the average ages of 34.5 and 24.7. The study showed that: • 20% and 27% had already received treatment for fertility. • Dysmenorrheal (pain during menstruation) was recorded on 100% and 87% of patients. • Deep dyspareunia (difficult or painful sexual intercourse) was recorded in 83% and 65% of patients. • 88% and 73% of patients experienced intermenstrual pain (pain between periods). The study found that quality of life was increased by most who had the surgery. Several authors have observed that digestive symptoms improve around 12 months and stay improved at 24 months post-op. The study found that some patients suffered constipation after surgery. Different patients experience varying degrees based on the type and severity of the treatment. Some studies have suggested that surgeries in which the conservative philosophy is used are less likely to cause constipation. This is because it does not penetrate into the bowel but stays on the outside. The author’s of this paper have summarised by saying that they feel more research is needed in this area and would like to see the results of a ‘randomised trial comparing colorectal resection with conservative surgery in deep endometriosis infiltrating the rectum’.

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