The Feasibility And Safety Of Nerve-sparing Surgery For Deep Infiltrating Endnmetriosis:a Meta Analysis

Objective: Our aim was to perform a meta-analysis to assess the feasibility and safety of nerve-sparing(NS)surgery for DIE compared with classical(Non-NS)surgery.Methods: In this meta-analysis,we searched PubMed,EMbase,Web of Sciense,CNKI,wanfang and vipp databases were searched by computer to collect the controlled trials and cohort studies of nerve-sparing surgery and classical(non-sparing)surgery for the treatment of deep infiltrating endometriosis(DIE).The retrieval time was from the database to February2019.After literature screening,data extraction and NOS evaluation of the literature quality included in the study,meta-analysis was performed using RevMan 5.3 software.Results: A total of 559 patients were enrolled in 8 studys(1 randomized controlled trial and 7 non-randomized controlled trials).Meta analysis results showed that:Compared with non-ns surgery group,NS surgery group treated deep infiltrating endometriosis(DIE)can reduce postoperative re-catheterization [OR=0.11,95%CI(0.02,0.71),P=0.02],postoperative bladder dysfunction [OR=0.16,95%CI(0.08,0.31),P<0.00001],postoperative rectaldysfunction [OR=0.22,95%CI(0.11,0.43),P<0.0001],postoperative sexual dysfunction [OR=0.12,95%CI(0.03,0.50),P=0.003].There were no statistically significant differences between the nerve-sparing surgery(NS)and non-sparing surgery(non-ns)groups in terms of operation time[MD=5.61,95%CI(-7.40,18.63),P=0.40],intraoperative blood loss[MD=5.25,95%CI(-4.04,14.53),P=0.27],length of hospital stay[MD=-0.80,95%CI(-1.77,0.17),P=0.11],and postoperative pain relief [OR=0.93,95%CI(0.29,2.94),P=0.90].Conclusion: compared with non-ns surgery,NS surgery for deep infiltrating endometriosis(DIE)has the advantages of less postoperative complications such as postoperative re-catheterization,postoperative bladder dysfunction,postoperative rectal dysfunction and postoperative sexual dysfunction.Given the limited number of included studies,more studies are needed to verify the above conclusions.