Postoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement

Abstract

Objective The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center.

Methods The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated.

Results One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively.

Conclusion Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.

Resumo

Objetivo O objetivo foi avaliar as taxas de complicações pós-operatórias e a necessidade de estomia temporária do tratamento cirúrgico laparoscópico para endometriose intestinal em um centro de referência.

Métodos Foram avaliados a indicação cirúrgica, tipo de operação, tempo operatório, tempo de internação, necessidade de estomia temporária, taxa de conversão para cirurgia aberta, complicações pós-operatórias.

Resultados Cento e cinquenta pacientes foram incluídos. A duração média da cirurgia foi significativamente maior para a ressecção segmentar (151 minutos) do que para a excisão do disco (111,5 minutos, p < 0,001) e shaving (96,8 minutos, p < 0,001). Pacientes com ressecção segmentar tiveram maior tempo de internação pós-operatória (1,87 dias) em comparação com pacientes com excisão de disco (1,43 dias, p < 0,001) e shaving (1,03 dias, p < 0,001). Um estoma temporário foi realizado em 2,7% dos pacientes. Complicações pós-operatórias de grau II e III ocorreram em 6,7% e 4,7% dos pacientes, respectivamente.

Conclusão A ressecção intestinal laparoscópica apresenta taxa aceitável de complicações pós-operatórias e baixa necessidade de estomia temporária.

Keywords

colorectal surgery - endometriosis - laparoscopy - postoperative complications - surgical stomas

Palavras-chave

cirurgia colorretal - endometriose - laparoscopia - complicações pós-operatórias - estomas cirúrgicos

Contributions

R. S. P.: Conception and design of the study, data collection, data analysis and interpretation, drafting of manuscript and figures, and critical revision of manuscript. F. P. V.: data collection, data analysis and interpretation; critical revision of the manuscript. H. P. C.: data collection, data analysis and interpretation, tables preparation; critical revision of the manuscript. M. R. F.: data analysis and interpretation, statistical analysis, and figure preparation; critical revision of the manuscript. J. V. C. Z.: data collection, data analysis and interpretation; critical revision of the manuscript. O. F.: supervision, critical revision of the manuscript. All authors contributed to the analysis and interpretation of data, revision of the manuscript for important intellectual content, granted final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Publication History

Received: 27 January 2022

Accepted: 28 June 2022

Article published online:
22 September 2022

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