Surgical treatment of symptomatic colorectal endometriosis

Fertil Steril. 1990 Mar;53(3):411-6. doi: 10.1016/s0015-0282(16)53332-9.


The approach to the treatment of bowel endometriosis has varied greatly. In this paper we present 77 consecutive patients with deep colorectal endometriosis treated with a full-thickness resection. Gynecologic procedures included conservative laparotomies for preserving fertility (39 patients); hysterectomy with bilateral salpingo-oophorectomy (29 patients); bilateral salpingo-oophorectomy (2 patients); left salpingo-oophorectomy (1 patient) and resection of pelvic endometriosis in patients with previous ablative surgery (6 patients). A low anterior bowel resection was performed in 68 patients (88.3%); a disc excision of the anterior rectal wall in 5 (6.5%); sigmoid resection in 3 (3.9%), and partial cecal resection in 1 (1.3%). The postoperative febrile morbidity was 10.4%, with no apparent anastomotic leaks. Of 33 patients who attempted to conceive postoperatively, 13 achieved a term pregnancy (39.4%). Complete relief of pelvic symptoms was obtained in 38 patients (49.4%); improvement in 30 (39%); no improvement in 8 (10.4%); and worsening of symptoms in 1 (1.2%). There has been no recurrence of symptomatic bowel endometriosis during 1 to 9 years of follow-up. Full-thickness resection of the colon for the treatment of deep bowel endometriosis is a safe procedure with low morbidity, good postoperative relief of symptoms, and favorable pregnancy rates.

MeSH terms

  • Adult
  • Colon / pathology
  • Colon / surgery
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / surgery*
  • Endometriosis / mortality
  • Endometriosis / surgery*
  • Female
  • Humans
  • Middle Aged
  • Postoperative Period
  • Pregnancy
  • Pregnancy Outcome
  • Rectum / pathology
  • Rectum / surgery