Surgical and clinical impact of extraserosal pelvic fascia removal in segmental colorectal resection for endometriosis.

STUDY

OBJECTIVE

To describe the characteristics of patients with colorectal endometriosis and extraserosal pelvic fascia (EPF) involvement and to assess the effect of EPF resection.

DESIGN

Prospective cohort study (Canadian Task Force classification II-2).

SETTING

University hospital.

PATIENTS: Two hundred twenty-seven patients who underwent segmental colorectal resection to treat symptomatic deep infiltrating endometriosis between 2001 and 2011, with or without EPF resection.

INTERVENTIONS: Segmental colorectal resection with or without EPF resection.

MEASUREMENTS AND MAIN

RESULTS

One hundred twelve patients (49.4%) required EPF resection. In these patients the total American Society for Reproductive Medicine endometriosis scores were higher (p = .004), there were more associated resected lesions of deep infiltrating endometriosis (p <.001), and the operative time was longer (p <.001). They were more likely to require blood transfusion (p = .003) and to experience intraoperative complications (p = .01) and postoperative voiding dysfunction (p = .04).

CONCLUSION

EPF infiltration reflects disease severity in patients with colorectal endometriosis. Its removal affects intraoperative morbidity and leads to a higher rate of voiding dysfunction.