Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis
Abstract Introduction Patients who have undergone colorectal surgery for symptomatic deep endometriosis may still encounter persistent or worsening digestive complaints. The aim of the present work was to analyze gastrointestinal function outcomes after radical and conservative colorectal surgery to...
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Wiley
2025-04-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.15023 |
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| author | Ezgi Darici Attila Bokor Daria Pashkunova Birgit Senft Nilüfer Cimşit Gernot Hudelist |
| author_facet | Ezgi Darici Attila Bokor Daria Pashkunova Birgit Senft Nilüfer Cimşit Gernot Hudelist |
| author_sort | Ezgi Darici |
| collection | DOAJ |
| description | Abstract Introduction Patients who have undergone colorectal surgery for symptomatic deep endometriosis may still encounter persistent or worsening digestive complaints. The aim of the present work was to analyze gastrointestinal function outcomes after radical and conservative colorectal surgery to further elucidate the effect of surgery on postoperative bowel function. Material and Methods PubMed, EMBASE, Web of Science, Clinical Trials.gov and the Cochrane Database databases were searched from January 1, 2010 until April 1, 2024. The quality of included studies was assessed by the Downs and Black quality checklist. Studies including patients with colorectal endometriosis who either underwent segmental resection (SR) or conservative approaches and reported data on bowel function were included. Results From the initial pool of 55 studies, 14 reported patient reported outcome measures eligible to be pooled in the meta‐analysis. Conservative surgery was less associated with constipation and increased number of daily stool (>3/day) when compared to SR (p = 0.02 and p = 0,0004, respectively). No difference was found in the occurrence of gas and stool incontinence (p = 0.72), postsurgical defecation pain (p = 0.44) and time to defer defecation (≤ 15 min; p = 0.64). Patients in the conservative surgery group reported higher postoperative Gastrointestinal Quality of Life Index (GIQLI) when compared to SR (p = 0.01). However, when comparing changes between pre‐ and postsurgical patient reported outcome measures within the respective groups, rather than evaluating postsurgical outcomes alone, none of the intervention groups showed significant changes between pre‐ and postsurgical GIQLI, Knowles Eccersley Scott Symptom Score(KESS) and Wexner scores (p = 0.28, p = 0.94 and p = 0.78, respectively). Conclusions Segmental resection seems to be associated with higher rates of post‐operative constipation and lower GIQLI scores when compared to conservative surgery. However, when comparing the change of gastrointestinal function symptoms reflected by changes of gastrointestinal function parameters from pre‐ to postoperative rather than focusing on purely postoperative parameters alone, no significant difference of these parameters was observed between surgical techniques. |
| format | Article |
| id | doaj-art-61b69bbdc1324d3f9974226950a57fe4 |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-61b69bbdc1324d3f9974226950a57fe42025-08-20T03:31:01ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-04-01104461562810.1111/aogs.15023Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysisEzgi Darici0Attila Bokor1Daria Pashkunova2Birgit Senft3Nilüfer Cimşit4Gernot Hudelist5Department of Obstetrics and Gynecology, Center for Endometriosis Semmelweis University Budapest HungaryDepartment of Obstetrics and Gynecology, Center for Endometriosis Semmelweis University Budapest HungaryDepartment of Gynecology, Center for Endometriosis Hospital St. John of God Vienna AustriaStatistix Statistical Calculations Company Klagenfurt AustriaÇerkeş State Hospital Çankırı TurkeyDepartment of Gynecology, Center for Endometriosis Hospital St. John of God Vienna AustriaAbstract Introduction Patients who have undergone colorectal surgery for symptomatic deep endometriosis may still encounter persistent or worsening digestive complaints. The aim of the present work was to analyze gastrointestinal function outcomes after radical and conservative colorectal surgery to further elucidate the effect of surgery on postoperative bowel function. Material and Methods PubMed, EMBASE, Web of Science, Clinical Trials.gov and the Cochrane Database databases were searched from January 1, 2010 until April 1, 2024. The quality of included studies was assessed by the Downs and Black quality checklist. Studies including patients with colorectal endometriosis who either underwent segmental resection (SR) or conservative approaches and reported data on bowel function were included. Results From the initial pool of 55 studies, 14 reported patient reported outcome measures eligible to be pooled in the meta‐analysis. Conservative surgery was less associated with constipation and increased number of daily stool (>3/day) when compared to SR (p = 0.02 and p = 0,0004, respectively). No difference was found in the occurrence of gas and stool incontinence (p = 0.72), postsurgical defecation pain (p = 0.44) and time to defer defecation (≤ 15 min; p = 0.64). Patients in the conservative surgery group reported higher postoperative Gastrointestinal Quality of Life Index (GIQLI) when compared to SR (p = 0.01). However, when comparing changes between pre‐ and postsurgical patient reported outcome measures within the respective groups, rather than evaluating postsurgical outcomes alone, none of the intervention groups showed significant changes between pre‐ and postsurgical GIQLI, Knowles Eccersley Scott Symptom Score(KESS) and Wexner scores (p = 0.28, p = 0.94 and p = 0.78, respectively). Conclusions Segmental resection seems to be associated with higher rates of post‐operative constipation and lower GIQLI scores when compared to conservative surgery. However, when comparing the change of gastrointestinal function symptoms reflected by changes of gastrointestinal function parameters from pre‐ to postoperative rather than focusing on purely postoperative parameters alone, no significant difference of these parameters was observed between surgical techniques.https://doi.org/10.1111/aogs.15023conservative surgerydeep endometriosisgastrointestinal functionsegmental resection |
| spellingShingle | Ezgi Darici Attila Bokor Daria Pashkunova Birgit Senft Nilüfer Cimşit Gernot Hudelist Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis Acta Obstetricia et Gynecologica Scandinavica conservative surgery deep endometriosis gastrointestinal function segmental resection |
| title | Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis |
| title_full | Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis |
| title_fullStr | Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis |
| title_full_unstemmed | Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis |
| title_short | Gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis: A systematic review and meta‐analysis |
| title_sort | gastrointestinal function outcomes following radical and conservative colorectal surgery for deep endometriosis a systematic review and meta analysis |
| topic | conservative surgery deep endometriosis gastrointestinal function segmental resection |
| url | https://doi.org/10.1111/aogs.15023 |
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