Standardization of endometriosis surgery – the coloproctologist's vision

Abstract

ObjectiveTo demonstrate the standardization of deep endometriosis surgery with intestinal involvement. MethodsProspective study evaluating 74 women undergoing standardized surgery for deep intestinal endometriosis. Divided into two groups, according to the findings of three-dimensional anorectal ultrasound, Group I with lesions affecting perirectal fat and Group II with lesions affecting at least the muscular layer of the rectum. ResultsThere was no statistically significant difference between the groups in relation to the size of the focus and the distance of the lesion to the puborectalis muscle (p>0.05). The type of surgery performed was laparoscopy without lesions in one patient (1.35%), disk resection in 13 patients (17.56%), shaving in 45 patients (60.81%), and rectosigmoidectomy in 15 patients (20.27%). The complications were bleeding from the drain with conservative treatment in three patients (4.05%), fistula in two patients submitted to the shaving method (2.70%), and three patients (4.05%) with lower anterior recession syndrome (LARS), with improvement from conservative treatment. Lesions in other organs were also observed during videolaparoscopy. ConclusionSurgical standardization is important to guide the general/colorectal surgeon in the effective approach of intestinal endometriosis.