Complications in surgical treatment of colorectal endometriosis
Chuprynin V.D., Smolnova T.Yu., Melnikov M.V., Chursin V.V., Buralkina N.A., Vardanyan M.A.
In colorectal endometriosis, surgery may involve techniques such as shaving, disc excision or segmental resection with anastomosis (either using hardware or manual methods). A two-stage intestinal resection with stoma removal followed by restoration of intestinal integrity is performed in case of multifocal infiltrative forms. However, it is the order and extent of surgical treatment that is debatable for some patient groups.
The article discusses various approaches to the surgical treatment of colorectal endometriosis. Colorectal endometriosis is the most severe type of deep endometriosis, among all other types. Complications, such as intestinal obstruction, bleeding, and perforation may occur in 4–13% of cases. Surgical intervention is the only effective treatment method. There can be the following types of surgery: segmental bowel resection (35.8%), shaving (31.9%), disc excision (23.1%). Combined treatment is used in 2.9% of cases. According to the Clavien–Dindo classification, perioperative complications range from 10 to 14% (anastomotic failure with the development of pelvic abscesses – 6.6%, rectovaginal fistulas – 3.8%, intestinal paresis in the postoperative period – 12.7%, severe dysuric disorders – 1.5%, hydronephrosis – 4.5%). The frequency of complications depends on several factors, including the surgical access, the size of the infiltrate, the depth of the lesion, and intraoperative approaches.
Conclusion: Colorectal surgery for endometriosis is a high-tech surgical procedure that requires a personalized approach at all stages of treatment. This includes preoperative imaging to create a detailed map of the affected area, which can help to develop an individual treatment plan.
Authors’ contributions: Chuprynin V.D. – developing the concept of the study, editing the text; Smolnova T.Yu. – developing the design of the study, selection of literature, writing the text, editing the text; Melnikov M.V. – developing the design of the study, editing the text; Chursin V.V. – editing the text; Buralkina N.A. – editing the text, selection of literature; Vardanyan M.A. – selection of literature.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article was written in accordance with the state assignment ‘Development of an apparatus for discoid transrectal resection of the distal part of the colon for its neoplasms. New approaches, indications, contraindications, technical conditions’, No. MHJG-2024-0034.
For citation: Chuprynin V.D., Smolnova T.Yu., Melnikov M.V., Chursin V.V., Buralkina N.A., Vardanyan M.A. Complications in surgical treatment of colorectal endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (10): 36-41 (in Russian)
https://dx.doi.org/10.18565/aig.2025.177
Keywords
deep endometriosis
colorectal endometriosis
segmental bowel resection
disc excision
shaving
infertility
complications
fistula
anastomotic failure
laparoscopy
robotic surgery
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Received 30.06.2025
Accepted 24.10.2025
About the Authors
Vladimir D. Chuprynin, PhD, Head of the Surgery Department, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 117997, Russia, Moscow, Oparin str., 4,v_chuprynin@oparina4.ru, https://orcid.org/0009-0003-7856-2863
Tatyana Yu. Smolnova, Dr. Med. Sci., Senior Researcher at the Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, +7(926)310-80-90, smoltat@list.ru, Scopus Author ID: 6504317244, https://orcid.org/0000-0003-3543-651X
Mikhail V. Melnikov, PhD, Head of Clinical Work at the Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, m_melnikov@oparina4.ru, https://orcid.org/0009-0007-2792-7200
Natalya A. Buralkina, Dr. Med. Sci., Senior Researcher at the Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, natalyaburalkina@yandex.ru, https://orcid.org/0000-0001-5109-6725
Mariam A. Vardanyan, PhD Student at the Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, mv132013@mail.ru; https://orcid.org/0009-0002-4619-1431
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