Surgical strategy for simultaneous deep endometriosis involving the rectum and ileocecal region
Goncharov A.L., Bekova M.A., Kalinina A.A., Kabeshov A.M., Levshin F.A., Tsechoeva Zh.R.
Intestinal endometriosis is diagnosed in 30% of patients with deep endometriosis (DE). Simultaneous involvement of both the right and left colonic segments poses a significant technical challenge, requiring surgeons to choose between staged sequential procedures and a single, simultaneous intervention.
Objective: To evaluate the feasibility, safety, and efficacy of simultaneous (single-stage) laparoscopic bowel resections in patients with DE affecting both sides of the intestinal tract.
Materials and methods: A retrospective analysis of surgical outcomes was conducted in patients who underwent simultaneous laparoscopic resection for multifocal intestinal endometriosis. A total of 110 patients with DE who required resection of one or more bowel segments were included in the study. Combined right- and left-sided intestinal involvement was identified in 35 of 110 (31.8%) patients with DE. The parameters assessed included operative duration, complication rate, and length of the recovery period.
Results: This study confirmed that simultaneous laparoscopic interventions for combined right- and left-sided intestinal involvement are technically feasible, safe, and effective. The mean operative time was 283±110 min, and the mean early recovery period was 3.45±0.95 days (range: 2–6 days). Postoperative complications were recorded in four of 35 (11.4%) patients. One case involved suppuration of the periumbilical postoperative wound, and the other involved intestinal hemorrhage from the sigmoidorectal anastomosis, requiring emergency colonoscopy and clipping. No anastomotic dehiscence of the right colonic segment was observed in any patient in the study group. In one patient, clinical signs of sigmoidorectal anastomotic dehiscence involving less than one-quarter of the circumference developed on postoperative day 5 following simultaneous resection of the rectum and ileocecal region. In one additional case, suture line failure following ureteral repair necessitated nephrostomy.
Conclusion: A comprehensive multidisciplinary approach utilizing contemporary surgical technologies enables optimal perioperative outcomes with a low risk of complications. The data obtained indicate the promise of further development and clinical implementation of simultaneous resection techniques for managing advanced forms of deep endometriosis.
Authors' contributions: Goncharov A.L., Bekova M.A., Kabeshov A.M., Levshin F.A. – conception and design of the study; Goncharov A.L., Bekova M.A., Kalinina A.A., Kabeshov A.M., Levshin F.A., Tsechoeva Zh.R. – data collection and processing; Kalinina A.A., Tsechoeva Zh.R. – statistical analysis; Goncharov A.L., Kalinina A.A., Kabeshov A.M., Tsechoeva Zh.R. – drafting of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the Central Clinical Hospital with Polyclinic of the Administrative Directorate of the President of the Russian Federation.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Goncharov A.L., Bekova M.A., Kalinina A.A., Kabeshov A.M., Levshin F.A., Tsechoeva Zh.R.
Surgical strategy for simultaneous deep endometriosis involving the rectum and ileocecal region.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (4): 106-113 (in Russian)
https://dx.doi.org/10.18565/aig.2025.362
Keywords
intestinal endometriosis
segmental bowel resection
simultaneous resection
deep endometriosis
laparoscopic surgical strategy
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Received 09.12.2025
Accepted 09.04.2026
About the Authors
Artem L. Goncharov, PhD, Colorectal Surgeon, Head of the Coloproctology Department, Central Clinical Hospital with Polyclinic of the Administrative Directorate of the President of the Russian Federation, 15 Marshala Timoshenko str., Moscow, 121359, Russia; Staff member, Endometriosis Surgery Center, Hospital of Fomin Michurinsky Clinic LLC, 15A Michurinsky Ave., Floor 2, Office 5, Moscow, 119192, Russia, goncharovartemleo@gmail.com, https://orcid.org/0000-0002-1326-7893Madina A. Bekova, PhD, Gynecologist, Medical Holding «SM-Clinic», 8-1, Ak. Anokhina str., Moscow, 119602, Russia, bekova.madina@yandex.ru,
https://orcid.org/0000-0002-2362-433X
Filipp A. Levshin, Gynecologist, Head of the Department of Operative Gynecology, Hospital of Fomin Michurinsky Clinic LLC, 15A Michurinsky Ave., Floor 2, Office 5, Moscow, 119192, Russia, fillalex1@yandex.ru, https://orcid.org/0000-0002-1702-0847X
Alexander M. Kabeshov, Obstetrician-Gynecologist, Specialist in Operative Laparoscopy in Gynecology, Hospital of Fomin Michurinsky Clinic, LLC, 15A Michurinsky Ave.,
Floor 2, Office 5, Moscow, 119192, Russia, kabeshovalexander@gmail.com, https://orcid.org/0000-0001-8928-3454
Alexandra A. Kalinina, 5th Year Student, Institute of Clinical Medicine, Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University), 1-6 Ostrovityanov str., Moscow, 117513, Russia, +7(909)975-25-25, sasha.k.msk@gmail.com, https://orcid.org/0009-0006-0304-051X
Zhannati-Ferdovs R. Tsechoeva, 5th Year Student, Institute of Medicine, Ingush State University, 7 Idrisa Zyazikova Ave., Magas, Republic of Ingushetia, 386001, Russia, jannetta301@mail.ru, https://orcid.org/0009-0008-5388-677X
Corresponding author: Alexandra A. Kalinina, sasha.k.msk@gmail.com
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