Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications.
Background: Endometriosis of the bowel can be associated with significant morbidity. Surgery to remove it carries risks. Options include conservative shaving or discoid resection and more radical segmental bowel resection. Aims: To determine if more conservative shaving or discoid bowel resection is...
| Publicado en: | Australian & New Zealand Journal of Obstetrics & Gynaecology Vol. 61; no. 2; pp. 169 - 177 |
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| Autores principales: | , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149847619&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149847619 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048666 Q4M jtl: Australian & New Zealand Journal of Obstetrics & Gynaecology issn: 00048666 maglogo: Y pubinfo: dt: Apr2021 vid: 61 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 149847619 148587249 149847619 149847619 10.1111/ajo.13311 149847619 ppf: 169 ppct: 8 formats: tig: atl: Conservative vs radical bowel surgery for endometriosis: A systematic analysis of complications. aug: au: Heinz‐Partington, Sean Costa, Walter Martins, Wellington P. Condous, George affil: Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Sydney New South Wales,, Australia sug: subj: Endometriosis Surgery Intestines Surgery Surgery, Operative Methods Postoperative Complications Human Systematic Review Cochrane Library CINAHL Database Embase PubMed Checklists ab: Background: Endometriosis of the bowel can be associated with significant morbidity. Surgery to remove it carries risks. Options include conservative shaving or discoid resection and more radical segmental bowel resection. Aims: To determine if more conservative shaving or discoid bowel resection is associated with fewer risks than more radical segmental resection. Material and Methods: This study is a systematic review. We considered eligible any cohort, observational or randomised controlled trial (RCT) study of at least ten women per arm comparing conservative vs radical bowel surgery for endometriosis. We divided complications into two groups, major and minor. One additional article was added due to its significance in answering our study question as well as the high quality of the study design as an RCT. Results: There were 3041 studies screened. Eleven studies were included (n = 1648). For major complications, the risk ratio for shaving and disc excision vs segmental resection is 0.31 (95% CI 0.21–0.46), while the risk difference is −0.25 (95% CI −0.41 to 0.10). For minor complications, the risk ratio is 0.63 (95% CI 0.36–1.09), while the risk difference is −0.03 (95% CI −0.12 to 0.05). Conclusions: Conservative shaving or discoid excision surgery is associated with reduced complications. Previous studies demonstrated a trend toward this finding, but suffered from relatively low participant numbers, increasing the risk of type one statistical error. Our results allow surgeons to make informed choices about potential complications when deciding how to approach bowel endometriosis. The results also allow patients to have more information about the risks. However, outcomes in the studies analysed are heterogenous and are from low‐quality evidence. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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