Material and methods
malignancy, endometriosis, infertility, pain
ENDOMETRIOSIS, INFILTRATION, COMPLICATION, SECONDARY, INFILTRATING
This study was designed in accordance with the Declaration of Helsinki and approved by the Institutional Ethical and Review Board of the University for the protection of human subjects (no.: 58723-4/2016/EKU) on 8 December 2016.We conducted a single-center, randomized, open-label, two-arm, parallel-group controlled trial to assess functional outcomes and endometriosis-related pain changes in women undergoing NOSE colectomy (NC) or conventional laparoscopic resection (CLR) for the management of colorectal DE between 30 September 2019 and 31 December 2020, at University Hospital. The secondary outcomes included complication rates and fertility outcomes. The mean follow-up time was 14±2.6 months.Inclusion criteria were being clinically diagnosed (by at least one imaging technique or via a previous surgery) as having intestinal deep infiltrating endometriosis up to 15 cm from the anus, involving at least the muscular layer in depth, and at least 50% of the recto-sigmoideal circumference in case of patients complaining of pain and/or infertility, and age 18–45 years. Ongoing pregnancy and suspected malignancy were excluded. Written informed consent was obtained from all patients before randomization.All selected women underwent clinical examination by a gynecologist experienced in colorectal surgery for endometriosis, as well as a transvaginal ultrasound examination. Transvaginal sonography was performed to assess whether the rectum was involved, and to estimate the depth of rectal wall infiltration according to the IDEA protocolThis work has been reported in line with the Consolidated Standards of Reporting Trials (CONSORT, Supplemental Digital Content 1, Flow diagram (CONSORT 2010) for study of patients, who underwent NOSE or conventional laparoscopic segmental resection for rectal DE.