Percutaneous cryoablation therapy for abdominal wall endometriosis: a systematic review and meta-analysis

Letícia Helena Kaça do Carmo, Stephanie Brito Ceolin de Faria, Sara Socorro Faria, Marília da Cruz Fagundes, Luís Lima, Laura Costa de Oliveira Lima, Susana Moreira, Sarah Verdan Moreira, Guilherme Strieder de Oliveira, Renata Vidal Leão, Emanuela Mendes Junqueira de Barros, E. Barros, Miriana Mariussi, Lucas Moretti Monsignore, Daniel Giansante Abud
The British journal of radiology · 2025 · vol. 98(1167) , pp. 345–353 · doi:10.1093/bjr/tqaf009 · PMID:39821247 · W4406463972
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Percutaneous cryoablation for abdominal wall endometriosis effectively reduces pain scores with high patient satisfaction and a low rate of adverse events.

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Abstract

OBJECTIVES: Abdominal wall endometriosis (AWE) consists of endometrial tissue between the peritoneum and the abdominal wall. The established treatment involves amenorrheic drugs-not always successful and tolerated-or invasive surgery. In this scenario, minimally invasive techniques such as cryoablation are a potential option. In this study, we primarily aimed to evaluate the efficacy of percutaneous cryoablation in reducing pain scores of AWE patients and analyze their satisfaction with the procedure and its related adverse events. MATERIALS AND METHODS: MEDLINE, EMBASE, and Cochrane's databases were systematically searched for studies that employed percutaneous cryoablation therapy for AWE and reported any of the outcomes of interest. The primary outcome was the reduction in the visual analog scale (VAS) score after treatment. R Software was used for the statistical analysis. Heterogeneity was assessed using I2 statistics. The Risk Of Bias In Non-Randomized Studies-of Interventions framework assessed potential bias in each selected study. RESULTS: We included 4 studies, containing 126 patients. All articles were retrospective studies. The difference between the VAS scores before and after treatment was on average 5.97 points (95% CI 5.42-6.52; P <.01; I2 = 0%). The pooled satisfaction rate among patients in the selected studies was 93.1% (95% CI 88.66-97.34; P = .51; I2 = 0%). The pooled prevalence of adverse events was only 5.48% (95% CI 1.71-11.20; P = .58; I2 = 0%). Bias analysis showed an overall moderate risk in all included articles. CONCLUSION: Our study demonstrated that cryoablation could reduce pain complaints in patients, while presenting a low incidence rate of adverse effects. Randomized clinical trials with a larger number of patients are necessary for greater conclusions. ADVANCES IN KNOWLEDGE: (1) AWE affects about 3.5% of women. The standard treatment is invasive surgery. (2) This meta-analysis demonstrated that cryoablation can effectively reduce pain scores while presenting a low rate of adverse effects. (3) Cryoablation is a feasible treatment for AWE, furthermore allowing shorter hospital stays and few complications for the patients.

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Outcome instruments

VAS-pain

Condition tags

endometriosis

MeSH descriptors

Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (42)

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