title: Long-term symptoms, quality of life, and fertility after colorectal resection for endometriosis: extended analysis of a randomized controlled trial comparing laparoscopically assisted to open surgery.
abstract: BACKGROUND
  To evaluate the long-term symptoms, quality of life (QOL), and fertility after colorectal resection for endometriosis.
  
  
  METHODS
  Extended analysis of a randomized controlled trial including 52 patients with colorectal endometriosis, comparing laparoscopically assisted to open colorectal resection. All included patients were invited to complete questionnaires evaluating the presence and intensity of symptoms and QOL using the SF-36 and fertility at a mean (SD) follow-up of 50.7 (13.8) months. We compared symptoms intensity and QOL before and after surgery at short- (mean follow-up of 19 months) and long-term (mean follow-up of 51 months).
  
  
  RESULTS
  Persistent improvement in QOL was noted after surgery without differences between short and long term. Self-catheterization >6 months was the sole factor decreasing the long-term QOL (P = 0.02). No difference in symptoms and QOL was noted according to the route. Among the 28 patients (53.8%) wishing to conceive, 12 (42.9%) conceived within a mean (SD) time of 17 (13) months. No difference in fertility including pregnancy after IVF was noted between the routes, but spontaneous pregnancy occurred only after laparoscopy (P = 0.016).
  
  
  CONCLUSIONS
  Symptoms and QOL improvements after colorectal resection last for over 4 years without difference between the routes. Thank to a lower intra- and postoperative complications and higher spontaneous pregnancy rate, laparoscopic colorectal resection should be the first surgical approach.
authors.affiliation: Department of Obstetrics and Gynecology, GRC-UPMC 6 (Centre Expert En Endometriose (C3E)), UMRS938, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France, cyril.touboul@gmail.com.
authors.forename: Cyril
authors.initials: C
authors.lastname: Touboul
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.forename: Gil
authors.initials: G
authors.lastname: Dubernard
authors.forename: Sonia
authors.initials: S
authors.lastname: Zilberman
authors.forename: Anne
authors.initials: A
authors.lastname: Thomin
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000328:Adult; D003108:Colonic Diseases / Q000150:complications / Q000601:surgery*; D003248:Constipation / Q000209:etiology; D004412:Dysmenorrhea / Q000209:etiology; D004414:Dyspareunia / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D018873:Pregnancy Rate; D011788:Quality of Life; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*