Ramezani Zahra, Goodarzi Saba, Rashidian Pegah, Mohammadian Shima, Rastad Hadis, Esmi Mona, Shafiee Arman, Bakhtiyari Mahmood
Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Eur J Obstet Gynecol Reprod Biol X. 2025 Jun 4;27:100405. doi: 10.1016/j.eurox.2025.100405. eCollection 2025 Sep.
To compare the clinical outcomes of laparoscopy and hysteroscopy in the treatment of symptomatic isthmocele using a systematic review and meta-analysis.
A comprehensive search of PubMed, Scopus, and Web of Science was performed until November 11, 2024. Studies evaluating outcomes of laparoscopy or hysteroscopy intervention for treating symptomatic isthmocele were included in this study. A random-effects model was employed for heterogeneous data. The study is registered in PROSPERO with registration number CRD420251028603.
Nine studies involving 797 patients were included. Hysteroscopy demonstrated significantly less intraoperative blood loss (SMD: -2.28, 95 % CI: -3.65 to -0.90) and shorter hospital stays (SMD: -2.62, 95 % CI: -3.52 to -1.72), but the operative time difference was non-significant. Both approaches were equally effective in symptom resolution and defect repair (OR: 0.80, 95 % CI: 0.21-2.97). However, laparoscopic repair was associated with better outcomes for dysmenorrhea improvement (OR: 3.46, 95 % CI: 1.42-8.45) and higher postoperative pregnancy rates (OR: 4.17, 95 % CI: 1.89-9.09). High heterogeneity was noted in some outcomes, reflecting variability in study designs and populations.
Both laparoscopy and hysteroscopy are effective in treating symptomatic isthmocele, with each approach offering distinct advantages. Hysteroscopy is less invasive with faster recovery and better fertility.
通过系统评价和荟萃分析比较腹腔镜手术和宫腔镜手术治疗有症状子宫峡部憩室的临床结局。
截至2024年11月11日，对PubMed、Scopus和Web of Science进行全面检索。本研究纳入评估腹腔镜或宫腔镜干预治疗有症状子宫峡部憩室结局的研究。对异质性数据采用随机效应模型。该研究已在PROSPERO注册，注册号为CRD420251028603。
纳入9项研究，共797例患者。宫腔镜手术术中出血量显著更少（标准化均数差：-2.28，95%置信区间：-3.65至-0.90），住院时间更短（标准化均数差：-2.62，95%置信区间：-3.52至-1.72），但手术时间差异无统计学意义。两种方法在症状缓解和缺损修复方面同样有效（比值比：0.80，95%置信区间：0.21 - 2.97）。然而，腹腔镜修复在改善痛经方面结局更好（比值比：3.46，95%置信区间：1.42 - 8.45），术后妊娠率更高（比值比：4.17，95%置信区间：1.89 - 9.09）。在某些结局中观察到高度异质性，反映了研究设计和人群的变异性。
腹腔镜手术和宫腔镜手术治疗有症状子宫峡部憩室均有效，每种方法都有独特优势。宫腔镜手术创伤较小，恢复更快，对生育影响更小。
Zotero 插件
