Bowel occult microscopic endometriosis in resection margins in deep colorectal endometriosis specimens has no impact on short-term postoperative outcomes

Abstract

Objective: To evaluate the impact of bowel occult microscopic endometriosis (BOME) implants on postoperative outcomes in patients treated with colorectal resection for deep infiltrating digestive endometriosis.

Design: Prospective series of consecutive patients with deep colorectal endometriosis managed by colorectal resection in our department from June 2009 to November 2014 and enrolled in the CIRENDO database (NCT02294825).

Setting: University tertiary referral center.

Patient(s): One hundred three patients managed by colorectal resection for deep infiltrating endometriosis.

Intervention(s): Histologic examination of colorectal resection specimens.

Main outcome measure(s): Patient characteristics, preoperative and 1-year postoperative symptoms and intraoperative findings were compared between women with and without BOME on specimen resection margins.

Result(s): In 15 cases, BOME was found in one (nine cases) or both resection limits (six cases). No statistical significance was found between BOME and height of colorectal anastomosis, length of the resected bowel specimen or depth of rectal wall infiltration. One patient with BOME underwent a second colorectal resection 5 years later for rectal recurrence. Comparison between the rates of dyschezia, diarrhea, constipation, bloating and overall values of GIQLI and KESS scores 1 and 3 years postoperatively showed no statistical significance between women with and without BOME.

Conclusion(s): BOME was found in 14.6% of specimen resection margins. No impact on either pelvic or digestive symptoms was observed after 1-year follow-up postoperatively.

Clinical trial registration number: NCT02294825.

Keywords: Bowel occult microscopic endometriosis; colorectal resection; endometriosis; microscopic implants; recurrence; resection margins.

Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.