When endometriosis invade the tissues, including the bowel wall by more than 5 mm, it is termed deep infiltrating endometriosis. Patients with bowel involvement typically experience symptoms such as constipation, diarrhea, tenesmus, and rectal bleeding. Surgical intervention is often the primary treatment option for these patients, offering significant improvements in pain, infertility, and digestive issues. Both gynecologists and general/colorectal surgeons are capable of performing this procedure.
A study by Nasseri et al., published in Colorectal Disease, sought to explore whether the specialty of the surgeon impacts surgical outcomes and postoperative complication rates in patients undergoing colorectal resection for deep infiltrating endometriosis. Utilizing data from the American College of Surgeons National Surgical Quality Improvement Program, the study analyzed the clinical, surgical, and postoperative characteristics of 745 patients.
The results revealed that gynecologists favored minimally invasive techniques and performed more concomitant procedures, such as hysterectomy, excision or fulguration of pelvic lesions, and ureterolysis, compared to general/colorectal surgeons. While the incidence of major complications was similar between the two groups, general/colorectal surgeons had a lower rate of minor complications. Additionally, multivariable regression analysis found no significant association between surgeon specialty and the occurrence of major complications.
The authors concluded that a multidisciplinary or dual surgery team approach is essential for optimizing surgical outcomes in deep infiltrative endometriosis requiring bowel resection.
