Pain Relief, Gastrointestinal Function, and Recurrence After Conservative versus Radical (Segmental Resection) Surgery for Bowel Endometriosis: A Prospective Cohort Study.

Background: Surgery represents a primary treatment option in selected cases of bowel endometriosis (BE), particularly in patients with significant symptoms or those unresponsive to medical therapy, and effectively improves patients' quality of life (QoL). Objective: This study compared postoperative clinical outcomes between conservative (shaving/disc excision) and radical (segmental resection) surgical approaches for bowel endometriosis, and provided supplementary real‑world evidence. Design: This prospective cohort study enrolled patients who underwent surgery for bowel endometriosis between February 2023 and September 2023. Settings: A university-affiliated hospital. Patients: A total of 33 patients were initially recruited; 2 patients were lost to follow-up, and 31 patients were finally included for analysis. Interventions: Patients underwent bowel lesion shaving, disc excision or segmental resection and anastomosis, with surgical strategies individualized according to disease conditions. Main Outcome: Postoperative outcomes included complication rates, improvement in clinical symptoms, recovery of gastrointestinal function, and postoperative recurrence rate. Measures: Patients were followed up at 6, 12, 18, and 24 months post-surgery. Gastrointestinal function was evaluated using the Gastrointestinal Quality of Life Index (GIQLI). Results: Consistent with previous evidence, both conservative and radical surgery yielded significant and comparable improvements in pelvic symptoms and QoL, with stable effects during the 2-year follow-up (all Conclusions: Both surgical strategies achieve favorable clinical benefits for bowel endometriosis. No obvious intergroup superiority was confirmed, and surgical selection should be individualized based on lesion characteristics.