Comparison of Laparoscopic Discoid Resection and Segmental Resection for Colorectal Endometriosis Using a Propensity Score Matching Analysis

J Minim Invasive Gynecol. 2018 Mar-Apr;25(3):440-446. doi: 10.1016/j.jmig.2017.09.019. Epub 2017 Oct 5.

Abstract

Study objective: Our primary endpoint was to compare the intra- and postoperative complications, whereas secondary endpoints were the occurrence of voiding dysfunction and evaluation of the quality or life of segmental and discoid resection in patients with colorectal endometriosis.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Tenon University Hospital in Paris.

Patients: Thirty-one 31 patients who underwent a conservative surgery and 31 patients who underwent.

Interventions: The 2 groups were compared using propensity score matching (PSM) analysis, with a median follow-up of 247 days (8.2 months).

Measurements and main results: Discoid colorectal resection was associated with a shorter operating time (155 vs 180 minutes, p = .03) and hospital stay (7 vs 8 days, p = .002) than segmental colorectal resection; however, a similar intra- and postoperative complication rate was found. A higher rate of postoperative voiding dysfunction was observed in the segmental resection group (19% vs 45%, p = .03) as well as duration of voiding dysfunction requiring bladder self-catheterization longer than 30 days (0 vs 22%, p = .005).

Conclusion: Our PSM analysis suggests the advantages of discoid resection because it results in a similar surgical complication rate to segmental resection but with advantages in operating time, hospital stay, and voiding dysfunction.

Keywords: Colorectal endometriosis; Deep infiltrating endometriosis; Discoid resection; Laparoscopy; Segmental resection; Voiding dysfunction.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Colonic Diseases / surgery*
  • Digestive System Surgical Procedures / methods
  • Endometriosis / surgery*
  • Female
  • Humans
  • Intraoperative Complications / etiology
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Propensity Score
  • Rectal Diseases / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult