Meta-analysis on Therapeutic Effect Between Single Laparoscopic Surgery and Postoperative Therapy by GnRHa in Endometriosis

Objective:To evaluate the efficacy of laparoscopic surgery combined gonadotropin-releasing hormone agonist(GnRHa) with laparoscopic surgery alone in the treatment of endometriosis.Methods:Based on the principles of evidence-based medicine,use Cochrane systematic review method to retrieve randomized controlled trials(RCT) published on Cochrane Library,PUBMED,CNKI,CBM,Wanfang,Chongqing VIP database between 2000 and 2011,which were mainly about laparoscopic surgery combined GnRHa therapy and laparoscopic surgery alone therapy in the treatment of endometriosis.Then use RevMan 5.0 software to do Meta analysis.Results:8 RCT were included,862 patients in total.All of the trials reached grade B based on the quality evaluation methods of allocation concealment,blinding,loss to follow-up,baseline level comparison and grading description.According to meta analysis,Symptom release rate and pregnancy rate in laparoscopic surgery combined GnRHa group were both much higher than laparoscopic surgery alone group(OR=4.30,95%CI为2.86～6.47,P0.01) .And the recurrence rate was much lower in laparoscopic surgery combined GnRHa group too(OR=0.18,95%CI:0.13～0.26,P0.01) .Conclusions:The efficacy of laparoscopic surgery combined GnRHa therapy is much better than laparoscopic surgery alone in the treatment of endometriosis.