Risk Factors For Endometriosis Recurrence After Surgery: System Evaluation And Meta Analysis

Objective：To systematically access the risk factors for endometriosisafter surgery.Methods：We search the electronic databases like Pubmed、EMBASE、CENTRAL、CNKI、VIP、Wangfang for studies about the risk factors ofendometriosis recurrence after surgery.We screened the studies according tothe inclusion and excursion criteria.Then we evaluated the quality of theincluded studies and extracted the data from the studies.Statistic analysiswas performed with Revman manager5.2.In our study，we calculated theincorporated relative risk（RR） and95%confidence interval（95%CI）of the included studies.Results:Fifteen cohort studies were included in our study. We take useof the Newcastle-Ottawa Scalefor assessingthe quality of the nonrandomizedstudies，and all these studies grade from6to8score.The meta analysisshowed the risk of recurrence was not significant difference between theexposure group and non-exposure group of patient who took use of medicine about endometriosis before surgery （RR=1.16,95%CI[0.95,1.43],P=0.15）.But the risk of recurrence was significant difference between theexposure group and non-exposure group of patient who got high r-AFS stage（RR=2.04,95%CI[1.65,2.52], P＜0.05） or had the history ofendometriosis surgery（RR=9.14,95%CI[2.44,34.25], P＜0.05）.Pregnancyafter surgery is a protective factor about recurrence （RR=0.50,95%CI[0.33,0.76], P＜0.05）. Besides these，young age at surgery and earlymenarche are also risk factors for recurrence，and both have significantdifference from old age at surgery and late menarche。Conclusion：The risk factors for recurrence of endometriosis includehigh r-AFS stage，history of endometriosis surgery，young age at surgery andearly menarche，but pregnancy after surgery is the protective factor forrecurrence. The conclusions need to be confirmed by more clinical studiesbecause of the limited quantity of the included studies.