Complex Endometriosis Center

Rectal resection involves complete removal of the rectum affected by deep endometriosis along with colorectal anastomosis(19). This approach is used by the CEC only in case of major stenosis(15). It was needed in about 30 cases from our series of 3,190 patients(17) nd only once in a series of more than 700 patients with lesions measuring more than 4 cm.

Such radical surgery is, however, associated with significantly higher rates of severe postoperative complications(19).

Indeed, more than 10% of patients undergoing rectal resection present with a rectovaginal fistula corrected by a stoma, but this risk can increase to 18% in case of lesions located in the lower rectum, close to the anal margin(21). This surgery also requires more extensive dissection, which may lead to neurological lesions that can impair bladder function. Indeed, numerous studies report use of a definitive bladder catheter in 10% of cases(19).

This is why the CEC only uses this type of surgery as a last resort.