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RESEARCH PRODUCT
Role of Ovarian Suspension in Preventing Postsurgical Ovarian Adhesions in Patients with Stage III-IV Pelvic Endometriosis: A Systematic Review.
Attilio Di Spiezio SardoLuigi Della CorteAmerigo VitaglianoJose CarugnoPierluigi GiampaolinoGloria CalagnaGiuseppe BifulcoGabriele Sacconesubject
Laparoscopic surgerymedicine.medical_specialtyOvarian suspension Postoperative ovarian adhesionsmedicine.medical_treatmentEndometriosis; Minimally invasive gynecologic surgery; Ovarian suspension Postoperative ovarian adhesions; Endometriosis; Female; Gynecologic Surgical Procedures; Humans; Laparoscopy; Ovary; Sutures; Tissue AdhesionsEndometriosisEndometriosisAdhesion (medicine)Tissue Adhesionslaw.inventionAbdominal wall03 medical and health sciences0302 clinical medicineGynecologic Surgical ProceduresSuture (anatomy)Randomized controlled trialMinimally invasive gynecologic surgerylawmedicineHumansEndometriosiStage (cooking)Laparoscopy030219 obstetrics & reproductive medicinemedicine.diagnostic_testSuturesbusiness.industryOvaryObstetrics and GynecologyMinimally invasive gynecology surgerymedicine.diseasePostoperative ovarian adhesionsSurgerymedicine.anatomical_structure030220 oncology & carcinogenesisOvarian suspensionFemaleLaparoscopybusinessdescription
Endometriosis is a benign complex gynecological condition with high morbidity that affects women of reproductive age. Pelvic adhesion formation represents a serious clinical challenge in the management of patients with endometriosis. Several interventions have been proposed over the last few years aiming to reduce post-operative ovarian adhesions formation. The aim of this study is to summarize the evidence of the efficacy of ovarian suspension in the prevention of post-operative ovarian adhesions formation in women undergoing laparoscopic surgery for stage III-IV endometriosis. The research was conducted using electronic databases. A review of the abstracts of all references retrieved from the search was conducted. Selection criteria for the systematic review included all randomized controlled trials (RCTs) and non-randomized studies (NRSs) of premenopausal women diagnosed with stage III-IV pelvic endometriosis who underwent ovarian suspension or no ovarian suspension (control group). RCTs were eligible for meta-analysis. Eight studies were included in the systematic review: 2 RCTs and 6 NRSs. In all studies, ovarian suspension was performed during surgery for stage III-IV endometriosis. The site of the suspension was the anterior abdominal wall in 76.8% of the cases. Five studies reported the use of Polypropylene (Prolene® Ethicon Inc., Somerville, NJ, USA) as suture for the suspension. Removal of the suspension suture in the post-operative period was reported in six studies. Pooled data based on meta-analysis of RCTs showed that women who underwent ovarian suspension had a significantly lower incidence of postoperative adhesions formation in particular of moderate-severe adhesions. Ovarian suspension may reduce the rate and severity of postoperative adhesions formation in women undergoing laparoscopy for the treatment of stage III-IV endometriosis, but RCTs with larger samples size are needed.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-07-05 | Journal of minimally invasive gynecology |