Abstract

Study objective: To compare clinical outcomes in women undergoing Segmental Resection (SR) or Linear Excision (LE) of intestinal Deep Infiltrating Endometriosis (DIE) lesions.
Design: Prospective, non-randomized, comparative cohort study.
Setting: Three tertiary referral centers for endometriosis surgery.
Participants: Fifty-six women with DIE lesions located in rectosigmoid undergoing surgical treatment.
Interventions: Surgical treatment of intestinal endometriosis with two techniques: SR (n=28) or LE (n=28); treatment choice was performed according to lesion characteristics by a shared decision-making process with standardized protocols in all hospitals. Measurements and Main
Results: Functional outcomes were assessed using the Knowles-Eccersley-Scott Symptom Questionnaire (KESS) and the Low Anterior Resection Syndrome (LARS) score preoperatively and at 3 and 6 months postoperatively. The SR group had significantly higher LARS scores in 3 months, meaning poorer intestinal functioning compared to LR, however both groups showed improvement over time. At 6 months, no significant difference was observed between groups in KESS scores.
Conclusion: Although SR may be associated with transient poorer bowel function, both techniques demonstrate functional recovery over time.

Keywords:Prospective studies; Postoperative complications; Constipation; Fecal incontinence; Endometriosis; Minimally invasive surgical procedures