Results

Centres

A total of 73 centres were registered with the BSGE between 2017 to 2020. Over this time period, the number of centres submitting data for registered operations each year increased from 56 to 66 (Figure 1). Four centres submitted registered operations for the first time in 2020, while seven previously registered centres did not register any operations in 2020. Out of 73 centres, 48 submitted registered operations every year, 13 only for 3 years, 8 only for 2 years and 4 only for 1 year.

Operations

Over the time period from 2017 – 2020, a total of 5916 operations were performed for deep endometriosis requiring pararectal dissection at BSGE-accredited centres (Figure 2). The total number of registered operations increased by an average of 13.5% per year between 2017-2019, then decreased by 49.4% between 2019-2020.
At a centre-level, 60 endometriosis centres had reduced operation numbers in 2020 compared with the average for 2017-2019, while 9 centres had increased numbers of operations. Overall, the annual median number of operations per centre decreased from 21 operations to 12.5 operations, with a median decrease in operations per centre of 51.0% (IQR 29.4% – 75.0%).
Between 2017 and 2019, on average 33.0% of patients had no surgery on the bowel, 60.2% underwent shaving of endometriosis from the bowel surface, 1.8% underwent a disc resection and 5.0% underwent resection of a segment of bowel. In 2020, 34.5%, 59.3%, 2.6% and 3.6% of patients underwent no bowel surgery, bowel shave, disc resection and segmental bowel resection respectively, which was not significantly different to previous years (p=0.08).

Regions

At a regional level, all 11 administrative regions of Great Britain had reduced numbers of BSGE-registered operations for endometriosis in 2020 compared with averages for 2017-2019, with a median 56.6% decrease (range 6.13% - 68.62%) (Figures, 3 Figure 4). Regions had a median of 1.49 deaths from COVID-19 per 1000 population (range 0.80 – 1.91). At a regional level, reduction in these operations was significantly correlated with COVID-19 death rates (r=0.56, 95% CI of r 0.048 – 1.00, p=0.037).