Surgical Outcomes in Patients With Endometriosis: A Systematic Review

Among women treated surgically for endometriosis-associated pain, comprehensive data are lacking on the proportions of patients who experience little or no symptom relief, develop recurrent symptoms, or require further surgical treatment for endometriosis. The aim of this study was to assess the efficacy of surgical procedures used to treat endometriosis-associated pain. Medline and Embase were searched on October 13, 2016. Articles referring to women undergoing surgery for the treatment of endometriosis-associated pain were screened by two independent investigators. For each included treatment arm, data were extracted for the proportion of patients reporting partial or no improvement after surgery for endometriosis-associated pain, pain recurrence, or requirement for further surgery. A total of 38 studies were included. Most studies did not report relevant outcomes to evaluate pain (71.1%) and recurrent surgery (68.4%). Of the women who underwent lesion excision, 11.8% reported no improvement in pain, and 22.6% underwent further surgery. Postoperative pain, recurrent pain, and adverse events were reported by 34.3%, 28.7%, and 14.8%, respectively, of patients who underwent excision or ablation of endometriosis combined with pelvic denervation and in 25.0%, 15.8%, and 8.1% of women who underwent lesion excision alone. Of the patients who were treated surgically for deep endometriosis affecting the bowel and/or bladder, 7.0% experienced recurrent symptoms, and 4.1% underwent further surgery. This review supports the findings of previous studies and highlights the need for standardized reporting and more detailed follow-up after surgery for endometriosis-associated pain. Pour les femmes ayant reçu un traitement chirurgical des douleurs liées à l'endométriose, on observe un manque de données sur la proportion de patientes qui éprouvent un soulagement partiel ou inexistant de leurs symptômes, qui connaissent une récidive des symptômes ou qui nécessitent des traitements chirurgicaux supplémentaires. Cette étude visait à évaluer l'efficacité des interventions chirurgicales utilisées pour traiter les douleurs liées à l'endométriose. Des recherches ont été menées dans Medline et Embase le 13 octobre 2016. Deux chercheurs indépendants ont évalué des articles faisant référence aux femmes qui subissent une intervention chirurgicale pour traiter les douleurs liées à l'endométriose. Pour chaque volet de traitement retenu, les données ont été extraites pour la portion de