Medium to long-term gastrointestinal outcomes following disc resection of the rectum for treatment of endometriosis using a validated scoring questionnaire.

OBJECTIVE: To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrome after disc resection for deeply infiltrative endometriosis (DIE) using a validated scoring system.

DESIGN: Retrospective study to assess the gastrointestinal functional outcomes after rectal disc resection for DIE using a validated scoring system.

SETTING: University tertiary referral centre.

PATIENTS: Women who underwent disc resection for endometriosis at Royal Hospital for Women and Prince of Wales Private Hospital between January 2012 and December 2013 were included.

MAIN OUTCOME MEASURE: Low anterior resection syndrome (LARS) score using a validated questionnaire.

RESULTS: Forty-one women met the inclusion criteria. The mean age was 40 ± 10 years (range 22-75 years). All procedures were performed laparoscopically. Eleven women (27%) underwent a hysterectomy in addition to rectal disc resection and endometriosis surgery. Mean operative time for the entire cohort was 158 ± 64 minutes, and mean length of hospital stay was 5 ± 2 days. Completed questionnaires were received from 31 women, a response rate of 76%. The mean length of follow-up was 17 ± 10 months (range 3-34 months). The LARS scores ranged from 0 to 34 (median 15, interquartile range 0-24). Eight women (26%) had a LARS score of 0. Nineteen women (61%) had a LARS score less than 21 (the threshold for LARS).

CONCLUSION: Conservative treatment of DIE with rectal disc resection is safe and feasible and is associated with mild gastrointestinal dysfunction in the medium to long term.