PAIN IMPROVEMENT AS A CLINICAL-SURGICAL OUTCOME IN ENDOMETRIOSIS: AN OVERVIEW
DOI:
https://doi.org/10.47820/recima21.v4i5.3102Keywords:
Endometriosis; pain; Laparoscopy; Surgical Procedures; systematic review.Abstract
Introduction: Endometriosis is characterized by chronic pelvic pain and infertility, affecting about 10-15% of women of reproductive age in the world. Aims: The study aims to gather evidence from systematic reviews on the effectiveness of laparoscopic surgery in the treatment of superficial and deep endometrial lesions, in terms of pain relief or clinical resolution. Methods: This is an overview of the systematic reviews published in the databases of MEDLINE/PubMed (National Library of Medicine), Virtual Health Library (VHL) of the Ministry of Health and Cochrane Library. Reviews with and without meta-analysis, with full text, without language restriction or publication date were selected. Results: The search resulted in 111 publications, and after reading the titles and abstracts, thirteen were selected. When compared to diagnostic laparoscopy, laparoscopic surgery reduced pain associated with endometriosis. Regarding the type of surgical technique, no significant difference was observed. Some studies have shown that laparoscopic surgery reduces pain in mild and moderate endometriosis, but it is unclear whether this is true in severe endometriosis. Conclusions: Although in medical practice the combination of clinical and surgical treatment proves to be effective in reducing and relieving patients' pain, a greater number of surgical trials with high methodological quality are needed to obtain definitive and current answers about the management of the disease.
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References
Maddern J, Grundy L, Castro J, Brierley SM. Pain in Endometriosis. Front Cell Neurosci 2020;14:590823. doi: 10.3389/fncel.2020.590823.
Duffy JM, Arambage K, Correa FJ, Olive D, Farquhar C, Garry R, Barlow DH, Jacobson TZ. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2014;(4):CD011031. doi: 10.1002/14651858.CD011031.pub2.
D’Hooghe TM, Hill III JA. Endometriose. In: Berek JS, ed. Tratado de Ginecologia: 14a edição. Rio de Janeiro: Guanabara Koogan; 2008. p. 842-7.
Singh SS, Gude K, Perdeaux E, Gattrell WT, Becker CM. Surgical Outcomes in Patients With Endometriosis: A Systematic Review. J Obstet Gynaecol Can 2020;42(7):881-8.e11. doi: 10.1016/j.jogc.2019.08.002.
Bafort C, Beebeejaun Y, Tomassetti C, Bosteels J, Duffy JMN. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2020; 10(10): CD011031. doi: 10.1002/14651858.CD011031.pub3.
Hsu AL, Sinaii N, Segars J, Nieman LK, Stratton P. Relating pelvic pain location to surgical findings of endometriosis. Obstetrics & Gynecology 2011; 118(2 Pt1):223-30. doi: 10.1097/AOG.0b013e318223fed0.
Budden A, Ravendran K, Abbott J. Identifying the problems of randomized controlled trials for the surgical management of endometriosis associated pelvic pain. J Minim Invasive Gynecol 2019, S1553465019312889. doi:10.1016/j.jmig.2019.11.002.
Miller LE, Bhattacharyya R, Miller VM. Clinical Utility of Presacral Neurectomy as an Adjunct to Conservative Endometriosis Surgery: Systematic Review and Meta-Analysis of Controlled Studies. Sci Rep 2020; 10(1):6901. doi: 10.1038/s41598-020-63966-w.
Perry R, Whitmarsh A, Leach V, Davies P. A comparison of two assessment tools used in overviews of systematic reviews: ROBIS versus AMSTAR-2. Syst Rev 2021;10(1):273. doi: 10.1186/s13643-021-01819-x.
De Marqui ABT. Evaluation of endometriosis-associated pain and influence of conventional treatment: a systematic review. Rev Assoc Med Bras 2015;61(6):507-18. doi: 10.1590/1806-9282.61.06.507.
Chaichian S, Kabir A, Mehdizadehkashi A, Rahmani K, Moghimi M, Moazzami B. Comparing the Efficacy of Surgery and Medical Therapy for Pain Management in Endometriosis: A Systematic Review and Meta-analysis. Pain Physician 2017;20(3):185-95. Available from: https://www.painphysicianjournal.com/current/pdf?article=NDMwNg%3D%3D&journal=104.
Jacobson TZ, Duffy JMN, Barlow DH, Koninckx PR, Garry R. Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database of Syst Rev 2009, Issue 4. Art. No.: CD001300. doi: 10.1002/14651858.CD001300.pub2.
Jones G, Jenkinson C, Kennedy S. Evaluating the responsiveness of the Endometriosis Health Profile Questionnaire: the EHP-30. Qual Life Res 2004; 13(3):705-13. doi: 10.1023/B: QURE.0000021316.79349.af.
Hart RJ, Hickey M, Maouris P, Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2008;16(2):CD004992. doi: 10.1002/14651858.CD004992.pub3.
Leonardi M, Gibbons T, Armour M, Wang R, Glanville E, Hodgson R, Cave AE, Ong J, Tong YYF, Jacobson TZ, Mol BW, Johnson NP, Condous G. When to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2020; 27(2):390-407.e3. doi: 10.1016/j.jmig.2019.10.014.
De Paula Andres M, Borrelli GM, Kho RM, Abrão MS. The current management of deep endometriosis: a systematic review. Minerva Ginecol 2017;69(6):587-96. doi: 10.23736/S0026-4784.17.04082-5.
Pundir J, Omanwa K, Kovoor E, Pundir V, Lancaster G, Barton-Smith P. Laparoscopic Excision Versus Ablation for Endometriosis-associated Pain: An Updated Systematic Review and Meta-analysis. J Minim Invasive Gynecol 2017;24(5):747-56. doi: 10.1016/j.jmig.2017.04.008.
Ouyang C, Fitch A, Cho KS, Driscoll J, Wang A, Lamvu G. Efficacy of excision versus ablation for improving endometriosis related pain: A systematic review and meta-analysis. J Endometr Pelvic Pain Disord 2022; 0(0). doi:10.1177/22840265221074850.
Referências de estudos primários (Somente dados publicados)
Sutton CJ, Ewen SP, Whitelaw N, Haines P. Prospective, randomised, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril 1994;62:696-700.
Abbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomised, placebo-controlled trial. Fertil Steril 2004;82:878-84.
Marcoux S, Maheux R, Berube S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 1997;337:217-22.
Tutunaru D, Vladareanu R, Dumitrascu MC, Alexandru B. Placebo effect of diagnostic laparoscopy alone in mild endometriosis. J Obstet Gynecol 2006;2:144.
Gad M, Badroui M. Evidence-based therapy for infertility associated with early stage endometriosis. Obstet Gynecol Int J 2012;2012:S548.
Moini A, Bahar L, Ashrafinia M, Eslami B, Hosseini R, Ashrafinia N. Fertility outcome after operative laparoscopy versus no treatment in infertile women with minimal or mild endometriosis. Obstet Gynecol Int J 2012;5(4):235-40.
Jarrell J, Mohindra R, Ross S, Taenzer P, Brant R. Laparoscopy and reported pain among patients with endometriosis. J Obstet Gynecol Canada 2005;27:477-85.
Wright J, Lotfallah H, Jones K, Lovell D. A randomised trial of excision versus ablation for mild endometriosis. Fertil Steril 2005;83:1830-6.
Healey M, Ang WC, Cheng C. Surgical treatment of endometriosis: a prospective randomised double-blinded trial comparing excision and ablation. Fertil Steril 2010;94:2536-40.
Barton-Smith P. An investigation of the surgical treatment of endometriosis. University of Surrey 2010. [Tesis M.D.]. University of Surrey. ISNI: 0000 0004 2698 9347. Available from: https://www.researchgate.net/publication/262291263_An_Investigation_of_the_Surgical_Treatment_of_Endometriosis
Riley KA, Benton AS, Deimling TA, Kunselman AR, Harkins GJ. Surgical excision versus ablation for superficial endometriosis-associated pain: a randomized controlled trial. J Minim Invasive Gynecol 2019;26:71-7. doi: 10.1016/j.jmig.2018.03.023.
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