Surgical treatment of colorectal endometriosis: an updated review

Rebecca J Schneyer; Kacey M Hamilton; Raanan Meyer; Yosef Y Nasseri; Matthew T Siedhoff

doi:10.1097/GCO.0000000000000960

Surgical treatment of colorectal endometriosis: an updated review

Curr Opin Obstet Gynecol. 2024 May 14. doi: 10.1097/GCO.0000000000000960. Online ahead of print.

Authors

Rebecca J Schneyer¹, Kacey M Hamilton¹, Raanan Meyer^{1

2}, Yosef Y Nasseri³, Matthew T Siedhoff¹

Affiliations

¹ Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
² The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel.
³ Department of General Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

PMID: 38743685
DOI: 10.1097/GCO.0000000000000960

Abstract

Purpose of review: This review aims to summarize recent literature on the surgical treatment of colorectal endometriosis.

Recent findings: The last decade has seen a surge in the number of studies on bowel endometriosis, with a focus on preoperative evaluation, perioperative management, surgical approach, and surgical outcomes. Many of these studies have originated from large-volume referral centers with varying surgical approaches and philosophies. Colorectal surgery for endometriosis seems to have a positive impact on patient symptoms, quality of life, and fertility. However, these benefits must be weighed against a significant risk of postoperative complications and the potential for long-term bowel or bladder dysfunction, especially for more radical procedures involving the lower rectum. Importantly, most studies regarding surgical technique and outcomes have been limited by their observational design.

Summary: The surgical management of bowel endometriosis is complex and should be approached by a multidisciplinary team. Methodical preoperative evaluation, including appropriate imaging, is vital for surgical planning and patient counseling. The decision to perform a more conservative or radical excision is nuanced and remains an area of controversy. High quality studies in the form of multicenter randomized controlled trials are needed before clear recommendations can be made.