Colorectal resection in endometriosis patients: correlation between histopathological findings and postoperative outcome

• Published in: European journal of medical research 2021-01, Vol.26 (1), p.12-12, Article 12
• Main Authors: Tschann, Peter, Vitlarov, Nikola, Hufschmidt, Martin, Lechner, Daniel, Girotti, Paolo N C, Offner, Felix, Abendstein, Burghard, Königsrainer, Ingmar
• Format: Article
• Language: English
• Subjects: Adult; Bowel involvement; Care and treatment; Colonoscopy; Colorectal resection; Constipation; Diarrhea; Digestive System Surgical Procedures - methods; Endometriosis; Endometriosis - complications; Endometriosis - pathology; Endometriosis - surgery; Female; Gynecology; Histochemistry; Histopathology; Hospitals; Humans; Hysterectomy; Infertility; Intestinal Diseases - etiology; Intestinal Diseases - pathology; Intestinal Diseases - surgery; Laparoscopy; Laparoscopy - methods; Medical research; Medicine, Experimental; Menstruation; Pain; Pain - etiology; Pain level; Patient outcomes; Patients; Postoperative Complications - epidemiology; Postoperative period; Quality of Life; Surgery; Surgical outcomes; Transplants & implants; Treatment Outcome; Womens health
• ISSN: 2047-783X; 0949-2321; 2047-783X
• DOI: 10.1186/s40001-021-00484-z

Endometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis are associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis. Twenty-five patients who underwent laparoscopic colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome. Average follow-up time was 38.68 months (± 19.92). Preoperative VAS-score was 8.32 (± 1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%) and anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (± 2.54). Our data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.