title: Does laparoscopic shaving for deep infiltrating endometriosis alter intestinal function? A prospective study.
abstract: BACKGROUND
  5-12% of deep infiltrating endometriosis involves the digestive tract, especially the distal sigmoid colon and rectum. Bowel endometriosis surgery may be associated with neurological complications.
  
  
  OBJECTIVE
  The aim of this study was to objectively evaluate whether excision of rectosigmoid deep infiltrating endometriosis by shaving technique alters intestinal and defecatory function at 6-months post-surgery.
  
  
  METHODS
  Nineteen women were enrolled in our tertiary care university hospital. They were affected by rectosigmoid endometriosis and underwent laparoscopic shaving excision of the nodule. Anorectal manometry was performed prior to and after surgery. The parameters studied were resting pressure, maximum squeezing pressure, pushing, rectoanal inhibitory reflex and rectal sensibility. The women completed a defecatory function questionnaire and ranked pain symptoms using a visual analogue scale.
  
  
  RESULTS
  After surgery, no alteration of rectoanal inhibitory reflex was found. The tone of the internal anal sphincter was not significantly different before and after surgery. The defecatory function questionnaire revealed a significant improvement in constipation, urgency, bowel movements and anal eczema. No cases of incontinence were described.
  
  
  CONCLUSIONS
  This report of the objective assessment of neurological intestinal alterations after rectal shaving of endometriotic nodules suggests the laparoscopic shaving technique preserves intestinal neurological activity.
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Seracchioli
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ferrini
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Montanari
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Raimondo
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Spagnolo
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Nadine
authors.initials: N
authors.lastname: Di Donato
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000502:physiology*; D003248:Constipation / Q000209:etiology; D003672:Defecation / Q000502:physiology*; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008365:Manometry; D011184:Postoperative Period; D011446:Prospective Studies; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*; D012810:Sigmoid Diseases / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
keywords: deep infiltrating endometriosis; intestinal function; rectosigmoid; shaving