Surgical Management of Deep Infiltrating Endometriosis: Advancing the Role of the Colorectal Surgeon

Endometriosis is a chronic, estrogen-dependent inflammatory condition affecting a substantial proportion of women of reproductive age, with considerable associated morbidity. In its deep infiltrating form, the disease frequently involves the rectum, sigmoid colon, and rectovaginal septum, posing complex clinical and surgical challenges. Although minimally invasive and robotic techniques have expanded therapeutic options, the field continues to face significant variation in diagnostic practices, surgical indications, and postoperative management. Recent advances in imaging, fertility-preserving strategies, and multidisciplinary care models have improved outcomes, yet the evidence base guiding colorectal surgical interventions remains fragmented. While key studies have explored operative techniques and associated outcomes, inconsistencies in international practice highlight substantial gaps in consensus and standardization. As deep endometriosis increasingly falls within the domain of colorectal surgery, there is a pressing need to establish clear clinical pathways, compare operative modalities, and develop robust postoperative care frameworks that account for both the burden of surgery and the risk of recurrence.This Research Topic aims to consolidate current evidence, stimulate new research, and provide practical guidance for surgeons managing colorectal endometriosis. Its goal is to define best practices for surgical decision making, explore the optimal balance between symptom relief, fertility preservation, and bowel function, and strengthen the collaborative role of colorectal surgeons within multidisciplinary endometriosis teams. The Topic invites submissions investigating when and how to operate, how different techniques influence rates of surgical morbidity and disease recurrence, and how surgical innovation can align with patient-centered care. It seeks to answer pivotal questions regarding disease recurrence, complication management, and long-term quality of life following colorectal resections.To gather further insights at the interface of colorectal surgery and endometriosis management, we welcome articles addressing, but not limited to, the following themes:• Comparative outcomes of shaving, discoid excision, and segmental resection techniques;• Minimally invasive and robotic techniques or approaches for colorectal endometriosis;• Preoperative workup and imaging modalities, including MRI and rectal endoscopic ultrasound;• Multidisciplinary team structures and the evolving role of the colorectal surgeon;• Fertility preservation and reproductive outcomes following bowel surgery;• Postoperative bowel, urinary, and sexual function outcomes;• Anastomotic and procedural complications: incidence, risk factors, and management;• Disease recurrence, predictors, and reoperation strategies;• Emerging hormonal and expectant management strategies as surgical alternatives or adjuncts;• Endometriosis in underrepresented groups, including adolescents and individuals with delayed diagnosis.We welcome original research, systematic reviews, meta-analyses, narrative reviews, and clinical perspectives that deepen understanding and enhance surgical outcomes in this complex and evolving field. Topic editors: Adam Truong, Beiqun Zhao, Niamh Foley Source: https://www.frontiersin.org/research-topics/83943/surgical-management-of-deep-infiltrating-endometriosis-advancing-the-role-of-the-colorectal-surgeon