Postoperative and long-term outcomes of nerve-sparing segmental rectal resection and complete nodular resection of rectal endometriosis

Background: Rectal endometriosis is a severe form of deep endometriosis affecting up to 12% of patients, causing significant pain and bowel dysfunction. The optimal surgical approach can be individually tailored based on lesion size and localization as assessed by preoperative imaging. Objectives: To compare the postoperative and long-term clinical results of two alternative surgical approaches to symptomatic rectal endometriosis. Methods: A retrospective single-centre study of 115 patients who had surgical resection of rectal endometriosis either by complete nodular resection (CNR) (n=55) or segmental rectal resection (SRR) (n=60). The surgical approach was indicated based on #Enzian related presurgical transvaginal sonography. #Enzian C1-2 lesions were planned for CNR, and #Enzian C3 lesion for SRR. Postoperative pain and satisfaction data were collected. Main Outcome Measures: Satisfaction and change in pre-operative and post-operative pain symptoms and overall improvement in symptoms, urinary and bowel dysfunction measured at follow-up and complications following surgery. Results: