Drug Treatment Of Endometriosis Before Surgical Therapy With Surgery Alone Systematic Review

Objective:As the drug combined surgery with surgery alone for the treatment of endometriosis is beneficial is still controversial clinical issues, it is necessary to summarize relevant research to be evaluated. Methods:A comprehensive system of retrieval Pubmed, Cochrane Library, EMBASE, CBM, CNKI, VIP and other related databases and manually retrieve relevant professional journals, retrieval time until May2013. Included drug treatment of endometriosis before surgical therapy with surgery alone relevant research literature by two investigators independently screened and extracted data, in strict accordance with the criteria to evaluate the methodological quality of the included studies, and use RevMan5.0software for statistical analysis. Results:A total of two randomized controlled trials and six non-randomized controlled trials of692patients.(1) r-AFS stage:preoperative medications can reduce the total AFS, implants AFS, but to reduce adhesion AFS useless.[WMD=-9.60,95%CI(-11.42,-7.78), P <0.00001;WMD=-8.70,95%CI(-10.67,-6.73),P<0.00001;WMD=-0.90,95%CI (-3.42,1.62), P=0.48];(2) medications after surgery can shorten the operation time, reduce blood loss, shorter recovery time used exhaust.[WMD=-32.59,95%CI(-58.19,-6.99),P=0.01;WMD=-74.29,95%CI(-109.03,-39.55),P<0.0001;WMD=-6.38,95%CI(-11.12,-1.63),P=0.008];(3) efficiency:efficient drug therapy before surgery compared with surgery alone is high.[OR=3.32,95%CI(2.15,5.11),P<0.00001];(4)pregnancy:drug therapy after surgery on the pregnancy rate is not helpful.(5) with subgroup analysis showed that the drug treatment on the recurrence rate of operation is not clear. Conclusion:Patients with endometriosis surgery after drug treatment can reduce the AFS stage, reducing postoperative surgical time, reduce blood loss, shorter recovery time used exhaust. Surgery after drug treatment compared with surgery alone high efficiency; Drug therapy before surgery to improve the pregnancy rate is not helpful, the impact on the recurrence rate is not clear. Study on the quality and the literature is limited to the number of constraints, the need to be more clinical RCT to prove a higher quality.