title: Rectal shaving for deep endometriosis infiltrating the rectum: a 5-year continuous retrospective series.
abstract: OBJECTIVE
  To report postoperative outcomes after rectal shaving for deep endometriosis infiltrating the rectum.
  
  
  METHODS
  Retrospective study using data prospectively recorded in the CIRENDO database.
  
  
  METHODS
  University tertiary referral center.
  
  
  METHODS
  One hundred and twenty-two consecutive patients whose follow-up observation ranged from 1 to 6 years.
  
  
  METHODS
  Rectal shaving performed using ultrasound scalpel or scissors and plasma energy in 68 and 54 women, respectively.
  
  
  METHODS
  Postoperative digestive function assessed using standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index (GIQLI) and the Knowles-Eccersley-Scott-Symptom Questionnaire (KESS).
  
  
  RESULTS
  Nodules were between 1 and 3 cm, <1 cm, and >3 cm in diameter, in 73.7%, 11.5%, and 14.8% of cases, respectively. They were located on the middle (49.2%) and upper rectum (50.8%). Clavien-Dindo 3a, 3b, 4a, and 4b complications occurred in 0.8%, 5.7%, 1.6%, and 0.8% of cases, respectively. Excepting two rectal fistulas (1.6%), the majority of complications were not related to rectal shaving itself. Gastrointestinal scores revealed statistically significant improvement in digestive function and pelvic pain at 1 and 3 years after rectal shaving, but not constipation. Rectal recurrences occurred in 4% of patients, 2.4% of whom had segmental resection, 0.8% shaving, and 0.8% disc excision. Three years postoperatively, the pregnancy rate was 65.4% among patients with pregnancy intention, 59% of whom conceived spontaneously.
  
  
  CONCLUSIONS
  Our data suggest that rectal shaving is a valuable treatment for deep endometriosis infiltrating the rectum, providing a low rate of postoperative complications, good improvement in digestive function, and satisfactory fertility outcomes.
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France; Research Group EA 4308 Spermatogenesis and Male Gamete Quality, IHU Rouen Normandy, IFRMP23, Reproductive Biology Laboratory, Rouen University Hospital, Rouen, France. Electronic address: horace.roman@gmail.com.
authors: Horace
authors: H
authors: Roman
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Salwa
authors: S
authors: Moatassim-Drissa
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Noemie
authors: N
authors: Marty
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Mathilde
authors: M
authors: Milles
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Aurélie
authors: A
authors: Vallée
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Eulalie
authors: E
authors: Desnyder
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Emanuela
authors: E
authors: Stochino Loi
authors: Expert Center for Diagnosis and Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France.
authors: Carole
authors: C
authors: Abo
mesh_terms: D000328:Adult; D023881:Colonography, Computed Tomographic; D003248:Constipation / Q000209:etiology; D016208:Databases, Factual; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005298:Fertility; D006785:Hospitals, University; D006801:Humans; D008279:Magnetic Resonance Imaging; D017699:Pelvic Pain / Q000209:etiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011788:Quality of Life; D020127:Recovery of Function; D012002:Rectal Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012003:Rectal Fistula / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation
keywords: Colorectal endometriosis; colorectal resection; rectal endometriosis; shaving