Medium to long-term gastrointestinal outcomes following disc resection of the rectum for treatment of endometriosis using a validated scoring questionnaire.

ABSTRACT

OBJECTIVE: To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrome after disc resection for deeply infiltrative endometriosis (DIE) using a validated scoring system. DESIGN: Retrospective study to assess the gastrointestinal functional outcomes after rectal disc resection for DIE using a validated scoring system. SETTING: University tertiary referral centre. PATIENTS Women who underwent disc resection for endometriosis at Royal Hospital for Women and Prince of Wales Private Hospital between January 2012 and December 2013 were included. MAIN OUTCOME MEASURE: Low anterior resection syndrome (LARS) score using a validated questionnaire. RESULTS: Forty-one women met the inclusion criteria. The mean age was 40 ± 10 years (range 22-75 years). All procedures were performed laparoscopically. Eleven women (27%) underwent a hysterectomy in addition to rectal disc resection and endometriosis surgery. Mean operative time for the entire cohort was 158 ± 64 minutes, and mean length of hospital stay was 5 ± 2 days. Completed questionnaires were received from 31 women, a response rate of 76%. The mean length of follow-up was 17 ± 10 months (range 3-34 months). The LARS scores ranged from 0 to 34 (median 15, interquartile range 0-24). Eight women (26%) had a LARS score of 0. Nineteen women (61%) had a LARS score less than 21 (the threshold for LARS). CONCLUSION: Conservative treatment of DIE with rectal disc resection is safe and feasible and is associated with mild gastrointestinal dysfunction in the medium to long term.