8795 Impact of Surgical Procedures on Intestinal Function and Quality of Life in Patients with Deep Endometriosis: A Prospective Study

Abstract

<h3>Study Objective</h3> To analyze the prevalence of intestinal discomforts in patients with deep endometriosis (DE) and the alteration of different surgical procedures on their intestinal function and quality of life at short-term follow-up. <h3>Design</h3> A prospective cohort study. <h3>Setting</h3> A university-based tertiary obstetrics and gynecology hospital. <h3>Patients or Participants</h3> Patients with deep endometriosis infiltrating the rectum treated in the same medical team since April 1, 2018. <h3>Interventions</h3> Patients underwent rectal shaving, disk excision or segmental bowel resection depending on the severity of DE. <h3>Measurements and Main Results</h3> The primary end point was the prevalence of intestinal discomforts, pain symptoms ranked by VAS (visual analogue score). The secondary end points were values of gastrointestinal questionnaires, including GIQLI(gastrointestinal quality of life index), Wexner constipation score, CRADI-8 (colorectal-anal distress inventory 8),and SF 36 to evaluate quality of life. As of March 15, 2019,88 patients were enrolled, including 58 patients in group rectal shaving, 25 in disk excision and 5 in segmental bowel resection.59.04% (49/88) of patients had intestinal symptoms preoperatively, manifested as menstrual diarrhea 26(53.06%), bulge 19(38.78%)and hematochezia 13 (26.53%). However, postoperatively, the discomforts were mainly caused by diarrhea 10.23% (9/17) at 1-month follow-up(V1), constipation 40% (4/10) at 6-month follow-up(V6). According to the follow-up, there are significant improvement in dysmenorrhea in all three group, but the improvement of intestinal discomfort only in group shaving were significant 0(0,2) vs 0(0,0) at V1 and 0(0,2) vs 0(0,0) at V6,<i>P</i><0.05,respectively.Patients in group shaving had mild symptoms preoperatively, who had lower CRADI-8 and Wexner constipation scores than the other two groups. After surgical treatment, patients' gastrointestinal function were mild improved, but the SF-36 and the GIQLI score did not reach statistical significance among these 3 groups compared to the baseline. <h3>Conclusion</h3> For patients with complaints of periodic diarrhea, anal bulge and hematochezia, endometriosis should be considered. Although surgical procedures can improve patients' dysmenorrhea and intestinal discomfort, but, the occurrence of constipation in short term after surgery should be alert, especially in radical procedures.