Introduction Endometriosis affects the bowel in 3–37% of all cases.1There is ongoing debate regarding the necessity of either segmental resection or full-thickness disc rectal excision. This study aimed to review the use of the laparoscopic rectal shave technique with respect to outcomes and patient satisfaction.
Method Data was collected retrospectively for all patients requiring operative management of rectovaginal endometriosis between 2009 and 2014. Both electronic records and case notes were reviewed and data was collected on pre-operative symptoms, surgical procedure, length of stay, complication and re-admission rates and post-operative symptom recurrence. In addition patients answered a telephone satisfaction questionnaire.
Results 52 patients underwent surgery during the study period with 69.2% carried out by a combined colorectal and gynaecological surgical team. Average age was 33.9 (21–43). Out of 52 patients 90% underwent rectal wall shave, 8% had segmental resection and 2% hysterectomy in combination with rectal shave. Surgery was performed laparoscopically in 96% with a 0% conversion rate. Average length of stay was 1.5 days with a re-admission rate of 5.8%. Major complications occurred in 2% with no patients requiring re-operation within the early postoperative period. Overall 17.3% went on to have further surgery for their endometriosis although only 3.8% required bowel resection. Patient satisfaction levels were high with a high proportion of patients having symptom improvement post surgery.
Conclusion The laparoscopic rectal shave is a successful technique for the management of rectovaginal endometriosis with low complication rates and high patient satisfaction. Outcomes are improved by using combined colorectal and gynaecological surgical teams.
Disclosure of interest None Declared.
Revised American Society for Reproductive Medicine classificationof endometriosis: 1996. Fertil Steril. 1997;67:817–821