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Outcomes after rectosigmoid resection for endometriosis: a systematic literature review

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A Correction to this article was published on 09 July 2018

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Abstract

Purpose

“Endometriosis” is defined such as the presence of endometrial glands and stroma outside the uterine cavity. This ectopic condition may develop as deeply infiltrating endometriosis (DIE) when a solid mass is located deeper than 5 mm underneath the peritoneum including the intestinal wall. The ideal surgical treatment is still under search, and treatment may range from simple shaving to rectal resection. The aim of the present systematic review is to report and analyze the postoperative outcomes after rectosigmoid resection for endometriosis.

Methods

We performed a systematic review according to Meta-analysis of Observational Studies in Epidemiology guidelines. The search was carried out in the PubMed database, using the keywords: “rectal resection” AND “endometriosis” and “rectosigmoid resection” AND “endometriosis.” The search revealed 380 papers of which 78 were fully analyzed.

Results

Thirty-eight articles published between 1998 and 2017 were included. Three thousand seventy-nine patients (mean age 34.28 ± 2.46) were included. Laparoscopic approach was the most employed (90.3%) followed by the open one (7.9%) and the robotic one (1.7%). Overall operative time was 238.47 ± 66.82. Conversion rate was 2.7%. In more than 80% of cases, associated procedures were performed. Intraoperative complications were observed in 1% of cases. The overall postoperative complications rate was 18.5% (571 patients), and the most frequent complication was recto-vaginal fistula (74 patients, 2.4%). Postoperative mortality rate was 0.03% and mean hospital stay was 8.88 ± 3.71 days.

Conclusions

Despite the large and extremely various number of associated procedures, rectosigmoid resection is a feasible and safe technique to treat endometriosis.

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Change history

  • 09 July 2018

    The authors of the published version of this article missed to add the second affiliation of Mostafa Shalaby. The new affiliation is now added and presented correctly in this article. The remainder of the article remains unchanged.

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Authors and Affiliations

  1. Department of General Surgery and Surgical Specialties “Paride Stefanini”, Sapienza, University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Andrea Balla & Silvia Quaresima

  2. Department of Urology, Fundació Puigvert, Carrer de Cartegena 340, Universidad Autónoma de Barcelona, 08025, Barcelona, Spain

    José D. Subiela

  3. Department of General Surgery, University of Rome “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy

    Mostafa Shalaby, Giuseppe Petrella & Pierpaolo Sileri

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  1. Andrea Balla
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Andrea Balla, Silvia Quaresima, José D. Subiela, Mostafa Shalaby, Giuseppe Petrella, and Pierpaolo Sileri have no conflicts of interest or financial ties to disclose.

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Balla, A., Quaresima, S., Subiela, J.D. et al. Outcomes after rectosigmoid resection for endometriosis: a systematic literature review. Int J Colorectal Dis 33, 835–847 (2018). https://doi.org/10.1007/s00384-018-3082-y

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