Reproduction, Mother and Youth Health Unit, CHU de Québec-Université Laval Research Center, Quebec City, Quebec, Canada.
Department of Obstetrics and Gynaecology, Université Laval, Quebec City, Quebec, Canada.
PLoS One. 2023 May 23;18(5):e0285929. doi: 10.1371/journal.pone.0285929. eCollection 2023.
Endometriosis is a common gynecological condition with a wide range of symptoms, including infertility, dyspareunia, intestinal disorders, and pelvic pain. Laparoscopy and laparotomy are used widely for diagnosing and managing endometriosis. We will conduct a systematic review and meta-analysis with the aims of reporting complications rates following each type of surgeries for endometriosis and determinants of complications.
We will search Medline (via PubMed), Embase, the Cochrane Library, Web of Science, and Google Scholar for both retrospective and prospective cohorts or trials of at least 30 participants reporting perioperative and postoperative complications for endometriosis surgeries. We will restrict the studies to those conducted after 2011, to be representative of current practices, and will exclude studies of surgeries for gynecological cancer, or other concomitant benign gynecologic surgeries such as myomectomy. Two reviewers will independently screen references and select eligible studies. A standardized form will be used to collect data related to the baseline characteristics, potential determinants of complications, types of interventions, and outcomes. Cumulative incidences of complications will be pooled using DerSimonian and Laird random-effects method. The relation between potential determinants and complications will be reported with risk ratios and their 95% of confidence intervals. Subgroup analysis of surgical approach, surgical procedure, superficial and deep infiltrating endometriosis, and the indication of surgery will be conducted. Sensitivity analyses restricted to studies with low risk of bias will be performed.
This systematic review will provide information on the rates of complications for different surgical approaches and procedures for the treatment of endometriosis. It will contribute to inform patients when making decisions regarding their care. Identifying potential determinants of complications will also help to improve care by identifying women being at higher risk of complications.
Systematic review registration: CRD42021293865.
子宫内膜异位症是一种常见的妇科疾病，其症状广泛，包括不孕、性交困难、肠道紊乱和盆腔疼痛。腹腔镜检查和剖腹手术广泛用于诊断和治疗子宫内膜异位症。我们将进行系统评价和荟萃分析，旨在报告每种类型的子宫内膜异位症手术的并发症发生率以及并发症的决定因素。
我们将在 Medline（通过 PubMed）、Embase、Cochrane 图书馆、Web of Science 和 Google Scholar 中搜索至少 30 名参与者的回顾性和前瞻性队列或试验，这些研究报告了子宫内膜异位症手术的围手术期和术后并发症。我们将研究限制在 2011 年后进行的研究，以代表当前的实践，并排除妇科癌症手术或其他同时进行的良性妇科手术（如子宫肌瘤切除术）的研究。两位评审员将独立筛选参考文献并选择合格的研究。将使用标准化表格收集与基线特征、并发症潜在决定因素、干预类型和结局相关的数据。使用 DerSimonian 和 Laird 随机效应方法汇总并发症的累积发生率。将使用风险比及其 95%置信区间报告潜在决定因素与并发症之间的关系。将进行手术方法、手术程序、浅表和深部浸润性子宫内膜异位症以及手术指征的亚组分析。将进行仅限于低偏倚风险研究的敏感性分析。
本系统评价将提供关于不同手术方法和手术治疗子宫内膜异位症的并发症发生率的信息。它将有助于在患者做出有关其治疗的决策时提供信息。确定并发症的潜在决定因素也有助于通过识别面临更高并发症风险的女性来改善护理。
系统评价注册：CRD42021293865。
