Comparison of the main methods of surgical treatment of patients with colorectal endometriosis

Abstract

Objective. Comparison of the main methods of surgical treatment of patients with colorectal en-dometriosis. Material and methods. In the Department of Operative Gynecology of the V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology a comparative analysis of data from 161 patients operated on for colorectal endometriosis from 2015 to 2023 was accom-plished. The study was based on two methods of colorectal resection — the classical method using minilaparotomy and a method in which a one-stage circular resection of the affected intestine is performed followed by the imposition of an intestinal anastomosis using a suturing device. Results. The 1st group included 56 patients operated on using the NOSE (the natural orifice specimen enextraction — removal of a sample — endometrioid infiltrate — through natural openings) technique, of which 33 patients underwent surgery using a traditional laparoscopic approach (Ls) and 23 — using a robotic surgical complex. The 2nd group included 105 patients who underwent colorectal resection using the classical method (CLS) using minilaparotomy. Among them, 66 pa-tients were operated on using laparoscopic access (Ls) and 39 patients were operated using robot-ic access. A total of 4 complications were noted after colorectal resection using the NOSE tech-nique, no cases of pelvic abscess, rectovaginal fistula formation, or colonic anastomosis failure were detected. Conclusion. The introduction of NOSE technology in robot-assisted and laparoscopic colorectal resection reduces the duration of surgery by eliminating the extra-abdominal stage of the opera-tion, eliminates complications associated with a minilaparotomy incision, accelerates the rehabili-tation and recovery period and has a better cosmetic effect, significantly reduces the cost of lapa-roscopic surgery without reducing its reliability.