title: Laparoscopic colorectal resection for bowel endometriosis: feasibility, complications, and clinical outcome.
abstract: OBJECTIVE
  To evaluate the short- and long-term outcomes of laparoscopic colorectal resection for endometriosis.
  
  
  METHODS
  This study included 357 consecutive patients who underwent colorectal resection. We evaluated intraoperative and postoperative complications, symptom outcomes, and long-term follow-up.
  
  
  METHODS
  Three hundred forty-three patients (96.1%) underwent laparoscopic colorectal resection, and radical endometriosis ablation was in 334 patients (93.6%).
  
  
  RESULTS
  Fourteen (3.9%) required laparoconversion. Median operating time was 300 (range, 85-720) minutes, with a median estimated blood loss of 250 (range, 50-550) mL. Radical endometriosis ablation was achieved in 334 patients (93.6%). Median ileus was 4 (range, 1-8) days, with a median postoperative hospitalization of 8 (range, 3-36) days. Early and late complications were observed in 44 patients (12.3%) and, in 35 of these (79.5%), surgical management was necessary. Median follow-up after colorectal resection was 19.6 (range, 6-48) months. The median preoperative and postoperative dyspareunia scores were 8 (range, 4-10) and 3 (range, 0-10), respectively (P < .04), and the median preoperative and postoperative gastrointestinal tract symptom scores were 7 (range, 2-10) and 2 (range, 0-10), respectively (P < .05). During follow-up, 24 of 286 recurrences (8.4%) were registered. Patients who previously underwent surgery for endometriosis showed a higher risk of recurrence compared with patients undergoing primary surgery (13.2% vs 3.4%; P < .048).
  
  
  CONCLUSIONS
  Laparoscopic colorectal resection for severe endometriosis is feasible and markedly improved endometriosis-related symptoms. Despite the risk of major postoperative complications, the procedure shows good results in terms of recurrence rate and could be adopted as the primary approach for patients with symptomatic colorectal infiltrating endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Negrar, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Minelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.forename: Giacomo
authors.initials: G
authors.lastname: Ruffo
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceccaroni
authors.forename: Liliana
authors.initials: L
authors.lastname: Mereu
authors.forename: Stefano
authors.initials: S
authors.lastname: Landi
authors.forename: Paola
authors.initials: P
authors.lastname: Pomini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D003108:Colonic Diseases / Q000601:surgery*; D004715:Endometriosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery*; D016896:Treatment Outcome