End-to-end versus side-to-end anastomosis after bowel resection for deep infiltrating endometriosis: A retrospective study

Objective: Deep infiltrating endometriosis(DIE) of the bowel may require segmental bowel resection. The subse- quent reconstruction can be performed through an end-to-end(E-E) or a side-to-end (S-E)anastomosis, the latter being used in low resection due to the reduced risk of anastomotic leakage. This study aims at comparing those two anastomosis techniques in women submitted to bowel resection for DIE, in terms of post-operative morbid- ity and functional outcomes. Methods: This was a single-center retrospective study on women undergoing laparoscopic rectal resection for deep infiltrating endometriosis with subsequent E-E or S-E anastomosis performed according to the level of rec- tal resection. The two groups were compared for postoperative complication rates and functional outcomes by means of validated questionnaires. Results: The study population included 30 patients undergoing a S-E anastomosis (group A), and 49 cases under- going an E-E anastomosis (group B). No differences were found between the two groups in terms of length of hos- pital stay, anastomotic leakages, protective ileostomies and short-term complications. At follow up no differences were found between the two groups in terms of bowel function and pain symptoms. Conclusions: A S-E anastomosis in case of low rectal resections for DIE presents similar complication rates and functional outcomes compared with an E-E anastomosis.