| Object:To summarize the risk factors and recurrence of ovarian endometriosis after laparoscopic conservative surgery,and to provide reference for clinical treatment.Method:The databases of PubMed,web of science,EMBASE and the Cochrane library were searched to collect cohort studies or case-control studies of patients with ovarian endometriosis undergoing laparoscopic conservative surgery.The retrieval time was from the establishment of the database to June 18,2020.Two researchers independe-ntly screened the literature and extracted the data,then evaluated the bias risk of the included studies,and made a Meta-analysis using revmanger 5.4 software.The controversial parts were evaluated by a third party.Results:A total of 9 cohort studies and 4 case-control studies were included,including3118 patients.695 patients relapsed and 2423 did not.Meta analysis showed that the recurrence rate of patients with drug treatment history was higher,and the difference was statistically significant[RR=1.41,95%CI(1.11,1.77),P< 0.001].The age of recurrent group was younger than that of non recurrence group,and the difference was statistically significant[MD=-1.37,95%CI(-1.97,-0.77),P<0.00001].There was no significant difference in menarche age between recurrence group and non recurrence Group [MD =-0.12,95% CI(-0.31,0.11),P=0.31].The recurrence rate of patients with previous endometriosis related surgery was higher,the difference was statistically significant[RR=2.02,95%CI(1.02,4.00),P<0.05].Preoperative infertility had no signif-icant effect on postoperative recurrence,[OR=1.09,95%CI(0.82,1.45)].The recurre-nce rate of patients with dysmenorrhea increased significantly [OR= 1.95,95%CI(1.45,2.62),P<0.0001].There was no statistically significant difference in patients with uterine fibroids [OR=2.57,95%CI(0.86,7.64),P=0.09].The recurrence rate of adenomyosis was increased with statistically significant difference[RR= 1.85,95%CI(1.26,2.69),P<0.001].BMI had no significant difference for recurrence [MD=-0.01,95%CI(-0.34,0.32),P=0.96].CA125 value before operation had no statistical significance for recurrence [MD=13.7,95%CI(-10.69,38.10),P=0.27].Patients with family history had higher recurrence rate [RR=1.93,95%CI(1.11,3.36),P<0.05].Patients with endometriosis had higher recurrence rate than patients with family history,and the difference was statistically significant [RR=1.93,95% CI(1.11,3.36),P<0.05].The r·AFS stage of endometriosis had significant difference in recurrence rate,or was 0.36[OR=0.36,95%CI(0.20,0.63),P<0.001].The difference of cyst diameter for recurrence was statistically significant[MD =0.7,95%CI(-0.12,1.52),P=0.1].Conclusion:Combined with the published data,postoperative pregnancy is a protective factor for endometriosis recurrence,and the combination of uterine fibroids,menarche age,preoperative infertility history,BMI,preoperative CA125 level and cyst diameter have no influence on the recurrence.The recurrence factors of ovarian endometriosis were the history of drug treatment,operation history,dysmenorrhea,endometriosis related operation history,high r·AFS score,adenomyosis,positive family history and high disease stage.Clinical doctors should strengthen postoperative management according to the risk factors of recurrence. |
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