Laparoscopic ovarian cystectomy versus fenestration/coagulation or laser vaporization for the treatment of endometriomas: a meta-analysis of randomized controlled trials

Dan H, Han Dan, Feng Li-min, Feng Limin, Limin F
Gynecologic and obstetric investigation · 2013 · vol. 76(2) , pp. 75–82 · doi:10.1159/000351165 · PMID:23751250 · W2011015022
Systematic review / meta-analysis OA: closed CC0 ⤵ 55 in-corpus citations
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Laparoscopic ovarian cystectomy showed significantly lower recurrence rates and higher pregnancy rates compared to fenestration/coagulation or laser vaporization for treating endometriomas.

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Abstract

AIM: To compare outcomes after laparoscopic ovarian cystectomy versus fenestration/coagulation or laser ablation for the treatment of endometriomas. METHODS: Studies were identified by searching the PubMed, EMBASE, SCOPUS, and Cochrane Central Register of Controlled Trials databases using the terms ovarian, endometrioma or endometriosis, cystectomy, fenestration, coagulation, laser, and ablation or vaporization. The outcomes of interest were recurrence of signs/symptoms and endometrioma, reoperation, pregnancy, and ovarian reserve. RESULTS: Seven studies were included. The risk of recurrence of signs/symptoms after surgery was significantly lower for laparoscopic cystectomy compared with fenestration/coagulation [risk ratio (RR): 0.29; 95% CI: 0.15-0.55; I² = 0%; p < 0.001], as was the risk of recurrence compared with fenestration/coagulation (RR: 0.50; 95% CI: 0.26-0.97; I² = 0%; p = 0.04) and laser vaporization (RR: 0.33; 95% CI: 0.12-0.88; I² = 0%; p = 0.03). The risk of pregnancy was significantly higher for cystectomy compared with fenestration/coagulation (RR: 2.64; 95% CI: 1.49-4.69; I² = 0%; p < 0.001), but not laser vaporization (RR: 0.92; 95% CI: 0.30-2.80; p = 0.89). There were inadequate data for the meta-analysis of ovarian reserve. CONCLUSIONS: Our findings suggest that cystectomy provides better outcomes than fenestration/coagulation or laser ablation regarding recurrence of symptoms and endometrioma as well as pregnancy rate (fenestration/coagulation only). Further studies are needed to clarify the effect of these surgical approaches on ovarian reserve.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Laparoscopy Laparoscopy Laser Therapy Laser Therapy Ovarian Diseases Endometriosis Endometriosis Female Female Fertility Preservation Fertility Preservation Humans Humans Laser Coagulation Laser Coagulation Ovarian Diseases Ovarian Diseases Randomized Controlled Trials as Topic Randomized Controlled Trials as Topic

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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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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