Low anterior resection syndrome in patients undergoing bowel segmental resection for rectosigmoid endometriosis: A retrospective long-term follow-up study

Abstract

Aim

The aim of this work was to evaluate the prevalence of low anterior resection syndrome (LARS) and its long-term evolution following colorectal segmental resection for deep infiltrating endometriosis (DIE) and identify any associated risk factors.

Method

A retrospective observational study was conducted on 124 patients who underwent bowel segmental resection for DIE between 2008 and 2023 at a single tertiary centre. Postoperative rectal function was assessed using the LARS score, and logistic regression analysis was performed to identify independent risk factors for minor/major LARS.

Results

LARS was observed in 5.6% of patients, with 1.6% presenting minor LARS and 4.0% major LARS. Logistic regression identified parametrial resection (odds ratio = 6.2, p = 0.04) as an independent risk factor for minor/major LARS. LARS severity remained stable in all cases over a mean follow-up of 6.9 ± 3.7 years.

Conclusion

As for previously reported studies, our data highlight a relatively low prevalence of LARS following bowel DIE surgery with stable severity over time. Identifying parametrial resection as an independent risk factor underlines the critical need to recognize this specific aspect of endometriosis surgery, ensuring that it is thoroughly addressed during surgical planning and integrated into patient counselling for proper outcomes and expectations. Prospective studies are needed to confirm these findings, explore additional risk factors and better understand the factors influencing long-term outcomes in this patient population.