Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5316
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dc.contributor.authorLeonardi, Mathewen
dc.contributor.authorGibbons, Tatjanaen
dc.contributor.authorArmour, Mikeen
dc.contributor.authorWang, Ruien
dc.contributor.authorGlanville, Elizabethen
dc.contributor.authorHodgson, Ruth Maryen
dc.contributor.authorCave, Adele Een
dc.contributor.authorOng, Jozarinoen
dc.contributor.authorTong, Yui Yee Feliceen
dc.contributor.authorJacobson, Tal Zen
dc.contributor.authorMol, Ben Wen
dc.contributor.authorJohnson, Neil Pen
dc.contributor.authorCondous, Georgeen
dc.date.accessioned2023-06-28T01:33:52Z-
dc.date.available2023-06-28T01:33:52Z-
dc.date.issued2020-
dc.identifier.citationLeonardi, M., Gibbons, T., Armour, M., Wang, R., Glanville, E., Hodgson, R., Cave, A. E., Ong, J., Tong, Y. Y. F., Jacobson, T. Z., Mol, B. W., Johnson, N. P., & Condous, G. (2020). When to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysis. Journal of minimally invasive gynecology, 27(2), 390–407.e3. https://doi.org/10.1016/j.jmig.2019.10.014en
dc.identifier.urihttps://dora.health.qld.gov.au/qldresearchjspui/handle/1/5316-
dc.descriptionCairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Ruth Hodgsonen
dc.description.abstractObjective: We performed a systematic review and meta-analysis with the aim to answer whether operative laparoscopy is an effective treatment in a woman with demonstrated endometriosis compared with alternative treatments. Moreover, we aimed to assess the risks of operative laparoscopy compared with those of alternatives. In addition, we aimed to systematically review the literature on the impact of patient preference on decision making around surgery. Data sources: We searched MEDLINE, Embase, PsycINFO, ClinicalTrials.gov, CINAHL, Scopus, OpenGrey, and Web of Science from inception through May 2019. In addition, a manual search of reference lists of relevant studies was conducted. Methods of study selection: Published and unpublished randomized controlled trials (RCTs) in any language describing a comparison between surgery and any other intervention were included, with particular reference to timing and its impact on pain and fertility. Studies reporting on keywords including, but not limited to, endometriosis, laparoscopy, pelvic pain, and infertility were included. In the anticipated absence of RCTs on patient preference, all original research on this topic was considered eligible. Tabulation, integration, and results: In total, 1990 studies were reviewed. Twelve studies were identified as being eligible for inclusion to assess outcomes of pain (n = 6), fertility (n = 7), quality of life (n = 1), and disease progression (n = 3). Seven studies of interest were identified to evaluate patient preferences. There is evidence that operative laparoscopy may improve overall pain levels at 6 months compared with diagnostic laparoscopy (risk ratio [RR], 2.65; 95% confidence interval [CI], 1.61-4.34; p <.001; 2 RCTs, 102 participants; low-quality evidence). Because the quality of the evidence was very low, it is uncertain if operative laparoscopy improves live birth rates. Operative laparoscopy probably yields little or no difference regarding clinical pregnancy rates compared with diagnostic laparoscopy (RR, 1.29; 95% CI, 0.99-1.92; p = .06; 4 RCTs, 624 participants; moderate-quality evidence). It is uncertain if operative laparoscopy yields a difference in adverse outcomes when compared with diagnostic laparoscopy (RR, 1.98; 95% CI, 0.84-4.65; p = .12; 5 RCTs, 554 participants; very-low-quality evidence). No studies reported on the progression of endometriosis to a symptomatic state or progression of extent of disease in terms of volume of lesions and locations in asymptomatic women with endometriosis. We found no studies that reported on the timing of surgery. No quantitative or qualitative studies specifically aimed at elucidating the factors informing a woman's choice for surgery were identified. Conclusion: Operative laparoscopy may improve overall pain levels but may have little or no difference with respect to fertility-related or adverse outcomes when compared with diagnostic laparoscopy. Additional high-quality RCTs, including comparing surgery to medical management, are needed, and these should report adverse events as an outcome. Studies on patient preference in surgical decision making are needed (International Prospective Register of Systematic Review registration number: CRD42019135167).en
dc.language.isoenen
dc.relation.ispartofJournal of minimally invasive gynecologyen
dc.subjectInfertilityen
dc.subjectLaparoscopyen
dc.subjectPatient preferenceen
dc.subjectPelvic painen
dc.subjectQuality of lifeen
dc.titleWhen to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysisen
dc.typeArticleen
dc.identifier.doi10.1016/j.jmig.2019.10.014-
dc.identifier.pmid31676397-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.languageiso639-1en-
item.openairetypeArticle-
Appears in Sites:Cairns & Hinterland HHS Publications
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