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硬化疗法治疗卵巢子宫内膜异位症囊肿:系统评价和荟萃分析。

Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.

Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Fertil Steril. 2017 Jul;108(1):117-124.e5. doi: 10.1016/j.fertnstert.2017.05.015. Epub 2017 Jun 1.

Abstract

OBJECTIVE

To evaluate the efficacy of sclerotherapy for ovarian endometrioma on the risk of recurrence, clinical symptoms, and reproductive function.

DESIGN

Systematic review and meta-analysis.

SETTING

Not applicable.

PATIENT(S): Patients who underwent sclerotherapy of ovarian endometrioma.

INTERVENTION(S): An electronic-based search with the use of Pubmed, Embase, Ovid Medline, Google Scholar, Clinicaltrials.gov, and the Cochrane Central Register of Controlled Trials.

MAIN OUTCOME MEASURE(S): Recurrence rate, symptoms relief, fertility outcome, and adverse events.

RESULT(S): Eighteen studies were included in our review. The overall recurrence rates of endometrioma after sclerotherapy ranged from 0 to 62.5%. The risk of recurrence was significantly higher in women who were treated by means of ethanol washing than by means of ethanol retention. The number of oocytes retrieved was higher after endometrioma sclerotherapy compared with laparoscopic cystectomy, but clinical pregnancy rates were similar. There was no difference in the number of oocytes retrieved and the clinical pregnancy rates between the sclerotherapy-treated group with and the untreated group.

CONCLUSION(S): Sclerotherapy for ovarian endometrioma may be considered in symptomatic women who plan to conceive.

摘要

目的

评估卵巢子宫内膜异位症囊肿硬化治疗在复发风险、临床症状和生殖功能方面的疗效。

设计

系统评价和荟萃分析。

设置

不适用。

患者

接受卵巢子宫内膜异位症囊肿硬化治疗的患者。

干预措施

电子检索结合使用 Pubmed、Embase、Ovid Medline、Google Scholar、Clinicaltrials.gov 和 Cochrane 对照试验中心注册库。

主要观察指标

复发率、症状缓解、生育结局和不良反应。

结果

共纳入 18 项研究。硬化治疗后子宫内膜异位症囊肿的总体复发率为 0 至 62.5%。与乙醇保留治疗相比,乙醇冲洗治疗的患者复发风险显著更高。与腹腔镜囊肿切除术相比,子宫内膜异位症囊肿硬化治疗后可获得更多的卵母细胞,但临床妊娠率相似。硬化治疗组与未治疗组之间的卵母细胞数量和临床妊娠率无差异。

结论

对于计划妊娠的有症状妇女,可考虑对卵巢子宫内膜异位症囊肿进行硬化治疗。

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