Does Surgery Improve the Digestive Symptoms of Endometriosis?

The biggest improvement is seen when endometriosis is infiltrating the bowels, study finds

Key Points

Highlights: 

• Laparoscopic endometriosis surgery improves gastrointestinal symptoms the most when the disease is infiltrating the bowels.

Importance:

• This finding helps to guide decision-making concerning the surgery and counseling about the relation between individual symptoms and endometriosis lesion localization.

What's done here:

• This is a comparative retrospective study using data prospectively recorded in The North-West Inter-Regional Female Cohort for Patients with Endometriosis (CIRENDO).
• 1497 pelvic endometriosis patients [superficial (n=396), deep endometriosis sparing the bowel (n=337), and deep endometriosis involving the bowel (n=764)were compared.

Key results:

• Women with deep infiltrating endometriosis involving the bowels had the most improvement in gastrointestinal symptoms following laparoscopy.
• In women without deep infiltrating endometriosis, digestive complaints improved less after surgery.

Limitations:

• The data were obtained from patients from two referral centers and might not be valid universally.
• The results were based on answers to questionnaires, which include a big potential for bias.

Lay Summary

Women with deep infiltrating endometriosis involving the bowels have the most significant improvement in gastrointestinal symptoms following surgery. This is according to the findings of a comparative retrospective study in almost 1,500 women. 

“Women with severe bowel symptoms and deep endometriosis infiltrating the bowel should be informed about the high probability of symptom improvement after the removal of bowel nodules,” wrote the authors of the study that was published in the Journal of Minimally Invasive Gynecology.

The researchers’ aim was to understand how much endometriosis surgery in different locations can improve digestive symptoms caused by the disease.

Using data from The North-West Inter-Regional Female Cohort for Patients with Endometriosis (CIRENDO), they evaluated the gastrointestinal symptoms of 1,497 women before and after laparoscopic endometriosis surgery. Of these, 396 had superficial endometriosis, 337 had deep infiltrating endometriosis that spared the bowels, and 764 had deep infiltrating endometriosis involving the bowels. 

The team led by Dr. Horace Roman used the Gastrointestinal Quality of Life Index and Knowles-Eccersley-Scott-Symptom questionnaire and compared the degree of digestive symptom improvement following surgery between the three groups of women.

The results showed that women in the third group i.e. those with deep infiltrating endometriosis involving the bowel had the most significant improvement in gastrointestinal symptoms at the one-year evaluation following surgery. In women without deep infiltrating endometriosis, digestive complaints were improved less after surgery.

Research Source: https://pubmed.ncbi.nlm.nih.gov/34839059/