Recurrence after Surgery for Colorectal Endometriosis: A Systematic Review and Meta-analysis

Bendifallah S, Sofiane Bendifallah, Elie Vesale, Elie Vésale, Vesale E, Émile Daraï, Daraï E, Emile Daraï, Isabelle Thomassin-Naggara, Thomassin-Naggara I, Isabelle Thomassin‐Naggara, Marc Bazot, Bazot M, Tuech JJ, Jean-Jacques Tuech, Jean–Jacques Tuech, Abo C, Carole Abo, Horace Roman
Journal of Minimally Invasive Gynecology · 2019 · vol. 27(2) , pp. 441–451.e2 · doi:10.1016/j.jmig.2019.09.791 · PMID:31785416 · W2991039416
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This systematic review and meta-analysis investigated recurrence rates after surgical treatment for colorectal endometriosis.

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Abstract

ObjectiveThe recurrence rate after colorectal surgery for endometriosis is up to 50% at 5 years. The aim of the current review and meta-analysis was to assess recurrence associated with shaving, disc excision, and segmental resection for endometriosis with colorectal involvement.Data sourcesA systematic review was performed by searching the PubMed, ClinicalTrials.gov, EMBASE, Cochrane Library, and Web of Science databases for publications before February 28, 2019, using the terms "colorectal endometriosis" and "recurrence" in English. The outcome measure was histologically proven recurrence 1 year after the index surgery.Methods of study selectionStudies rated as good or fair by a study quality assessment tool were included. Two reviewers independently assessed the quality of the studies; discrepancies were discussed, and if a consensus was not reached, a third reviewer was consulted.Tabulation, integration, and resultsOf 156 relevant published trials, 41 were systematically reviewed and 4 were included in the meta-analysis. The risk of recurrence was higher after rectal shaving than after both segmental resection (odds ratio [OR], 5.53; 95% confidence interval [CI], 2.33-13.12; I2 = 0%; p = .001) and disc excision for histologically proven recurrence (OR, 3.83; 95% CI, 1.33-11.05; I2 = 0%; p = .01). This difference was not significant when comparing disc excision with segmental resection (OR, 2.63; 95% CI, 0.8-8.65; I2 = 0%; p = .11).ConclusionThe current analysis shows that the risk of recurrence is lower when segmental resection or disc excision is performed than when rectal shaving is performed. This finding is important when deciding the most appropriate surgical management.

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Condition tags

endometriosis

MeSH descriptors

Colonic Diseases Endometriosis Postoperative Complications Postoperative Complications Postoperative Complications Postoperative Complications Rectal Diseases Clinical Trials as Topic Clinical Trials as Topic Colonic Diseases Colonic Diseases Colonic Diseases Databases, Factual Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Endometriosis

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 (63)

Cited by (44)

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