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03.04.2017 | Gynecologic Endocrinology and Reproductive Medicine

Major and minor complications after anterior rectal resection for deeply infiltrating endometriosis

verfasst von: Stefan P. Renner, Hermann Kessler, Nalan Topal, Kim Proske, Werner Adler, Stefanie Burghaus, Werner Haupt, Matthias W. Beckmann, Johannes Lermann

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2017

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Abstract

Purpose

The aim of the present study was to analyze major and minor complications—including long-term impairment of intestinal, bladder, and sexual function—following surgery for deeply infiltrating endometriosis using anterior rectal resection.

Methods

Patients who had undergone anterior rectal resection due to endometriosis between 2001 and 2011 were included (n = 113). Clinical and surgical data, as well as minor and major complications, were recorded. A questionnaire was sent to the patients and also to a healthy control group (n = 100).

Results

Major complications occurred in 15.9% of cases and minor complications in 15%. Patients with postoperative ileostomies (n = 8) initially had ultralow anastomoses significantly more often. The questionnaire response rate was 77%, with a mean follow-up period of 85.9 months. Weak urinary flow was reported by 22.4% of the patients: a feeling of residual urine by 18.4%; more than one bowel movement/day by 57.5%; and insufficient lubrication during intercourse by 36.5%. These results differed significantly from the control group. Subgroup analysis showed no statistical associations between questionnaire responses and major or minor complications, ultralow anastomoses, bilateral dissection of the sacrouterine ligaments, or dissection of the vagina and rectovaginal space.

Conclusions

The major complication rate was consistent with the literature, but there were fewer minor complications. Patients with bowel anastomoses below 6 cm (ultralow) should receive information postoperatively about the high risk of insufficiency and should be closely monitored. The high rate of bladder, bowel, and sexual function impairment, and inadequate data make further prospective studies on this topic necessary.

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Titel: Major and minor complications after anterior rectal resection for deeply infiltrating endometriosis
verfasst von: Stefan P. Renner
Hermann Kessler
Nalan Topal
Kim Proske
Werner Adler
Stefanie Burghaus
Werner Haupt
Matthias W. Beckmann
Johannes Lermann
Publikationsdatum: 03.04.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 5/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4360-6

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Major and minor complications after anterior rectal resection for deeply infiltrating endometriosis