Cochrane · systematic review · CD011031
Laparoscopic surgery for endometriosis
Bafort, C, Beebeejaun, Y, Tomassetti, C, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
18
current version
GRADE rated
17
No studies
1
Included studies
NR
No studies 1 · 5.6%Ungraded 0 · 0%Very low 9 · 50%Low 7 · 38.9%Moderate 1 · 5.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyLaparoscopic treatment compared to diagnostic laparoscopy for endometriosis
Population: women with endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall pain scores unclear measurement instrument (6 months) Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Overall pain scores unclear measurement instrument (12 months) Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Live birth Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | NR | No studies |
Quality of life EQ‐5D index summary (6 months) Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | 1 study · 39 participants | Low Downgraded: imprecision |
Quality of life SF‐12 mental health component (6 months) Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | 1 study · 39 participants | Low Downgraded: imprecision |
Quality of life SF‐12 physical health component (6 months) Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | 1 study · 39 participants | Low Downgraded: imprecision |
Viable intrauterine pregnancy confirmed by ultrasound Laparoscopic treatment vs diagnostic laparoscopy | OR 1.89 [1.25, 2.86] | 3 studies · 528 participants | Moderate Downgraded: risk of bias |
Pregnancy loss: ectopic pregnancy per pregnancy Laparoscopic treatment vs diagnostic laparoscopy | OR 1.18 [0.1, 13.48] | 1 study · 100 participants | Low Downgraded: imprecision |
Pregnancy loss: miscarriage per pregnancy Laparoscopic treatment vs diagnostic laparoscopy | OR 0.94 [0.35, 2.54] | 2 studies · 112 participants | Low Downgraded: imprecision |
Adverse events: conversion to laparotomy Laparoscopic treatment vs diagnostic laparoscopy | no estimate extracted | 1 study · 341 participants | Low Downgraded: imprecision |
Laparoscopic ablation and uterine nerve transaction compared to diagnostic laparoscopy for endometriosis
Population: endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse events Laparoscopic ablation and uterine nerve transaction vs diagnostic laparoscopy | OR 0.33 [0.01, 8.32] | 1 study · 141 participants | Low Downgraded: imprecision |
Laparoscopic ablation compared to laparoscopic excision for endometriosis
Population: endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall pain scores (reduction in VAS at 12 months) Laparoscopic ablation vs laparoscopic excision | no estimate extracted | 1 study · 103 participants | Very low Downgraded: risk of bias, imprecision |
Helium thermal coagulator compared to electrodiathermy for endometriosis
Population: endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Quality of life (9 months) – EHP‐30 pain Helium thermal coagulator vs electrodiathermy | no estimate extracted | 1 study · 119 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life (9 months) – EHP‐30 control and powerlessness Helium thermal coagulator vs electrodiathermy | no estimate extracted | 1 study · 119 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life (9 months) – EHP‐30 emotional well‐being Helium thermal coagulator vs electrodiathermy | no estimate extracted | 1 study · 119 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life (9 months) – EHP‐30 social support Helium thermal coagulator vs electrodiathermy | no estimate extracted | 1 study · 119 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life (9 months) – EHP‐30 self‐image Helium thermal coagulator vs electrodiathermy | no estimate extracted | 1 study · 119 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Helium thermal coagulator vs electrodiathermy | no estimate extracted | 1 study · 192 participants | Very low Downgraded: risk of bias |
Laparoscopic surgery versus diagnostic laparoscopy for pain or subfertility related to endometriosis
Population: Women with mild to moderate endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall pain better or improved at 6 month Laparoscopic surgery vs diagnostic laparoscopy | OR 6.58 [3.31, 13.1] | 171 participants | Moderate Downgraded: risk of bias |
Overall pain better or improved at 12 month Laparoscopic surgery vs diagnostic laparoscopy | OR 10 [3.21, 31.17] | 69 participants | Low Downgraded: risk of bias, imprecision |
Live birth or ongoing pregnancy Laparoscopic surgery vs diagnostic laparoscopy | OR 1.94 [1.2, 3.16] | 382 participants | Moderate Downgraded: risk of bias, imprecision |
Clinical pregnancy Laparoscopic surgery vs diagnostic laparoscopy | OR 1.89 [1.25, 2.86] | 528 participants | Moderate Downgraded: risk of bias, imprecision |
Miscarriage (per pregnancy) Laparoscopic surgery vs diagnostic laparoscopy | OR 0.94 [0.35, 2.54] | 112 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse events Laparoscopic surgery vs diagnostic laparoscopy | no estimate extracted | NR | No studies |
Laparoscopic versus diagnostic laparoscopy and medical therapy for pain related to endometriosis
Population: Women with mild to moderate endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of women pain free at 12 months Laparoscopic vs diagnostic laparoscopy and medical therapy | OR 5.63 [1.18, 26.85] | 1 study · 35 participants | Low Downgraded: risk of bias |
Laparoscopic ablation versus laparoscopic excision for pain related to endometriosis
Population: Women with mild to moderate endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Reduction in overall pain score at 12 month Laparoscopic ablation vs laparoscopic excision | no estimate extracted | 1 study · 103 participants | Low Downgraded: risk of bias |
CI: Confidence interval Laparoscopic ablation vs laparoscopic excision | no estimate extracted | NR | No studies |