Voiding dysfunction after surgery for colorectal deep infiltrating endometriosis: an updated systematic review and meta-analysis.

IF 2.4 3区 医学 Q2 SURGERY
Alexandra Madar, Adrien Crestani, Patrick Eraud, Andrew Spiers, Alin Constantin, Fréderic Chiche, Elise Furet, Pierre Collinet, Cyril Touboul, Benjamin Merlot, Horace Roman, Yohann Dabi, Sofiane Bendifallah
{"title":"Voiding dysfunction after surgery for colorectal deep infiltrating endometriosis: an updated systematic review and meta-analysis.","authors":"Alexandra Madar, Adrien Crestani, Patrick Eraud, Andrew Spiers, Alin Constantin, Fréderic Chiche, Elise Furet, Pierre Collinet, Cyril Touboul, Benjamin Merlot, Horace Roman, Yohann Dabi, Sofiane Bendifallah","doi":"10.1007/s13304-025-02124-1","DOIUrl":null,"url":null,"abstract":"<p><p>To define the risk factors of post-operative voiding dysfunction according to the type of surgical procedure performed. A systematic review through PubMed, the Cochrane Library, and Web of Science databases was performed. The Medical Subject Headings terms aimed for English articles about colorectal endometriosis surgery and voiding dysfunction published until December 26, 2022 were used. The primary outcome was the occurrence of post-operative voiding dysfunction. Secondary outcome was the presence of a persistent voiding dysfunction at 1 month. MeSH terms included ''deep endometriosis'', ''surgery'', or ''voiding dysfunction''. Two reviewers (AM, PE) assessed the quality of each article independently. A Study Quality Assessment Tool was used to provide rating of the quality of the included studies. 22 studies were included in the final analysis. Rectal shaving was associated with less voiding dysfunction than segmental resection (OR 0.33; 95%CI [0.20: 0.54]; I<sup>2</sup> = 0%; p < 10<sup>-3</sup>). No difference was found between rectal shaving and discoid excision (OR 0.44; 95%CI [0.07: 2.84]; I<sup>2</sup> = 55%; p = 0.39), nor between discoid excision and segmental resection (OR 0.44; 95%CI [0.18: 1.09]; I<sup>2</sup> = 49%; p = 0.08). Conservative surgery (i.e., shaving and discoid) was associated with less voiding dysfunction than radical surgery (i.e., segmental resection) (OR 0.37; 95%CI [0.25: 0.55]; I<sup>2</sup> = 0%; p < 10<sup>-3</sup>). Regarding persistent voiding dysfunction, rectal shaving and discoid excision were less associated with voiding dysfunction than segmental resection (respectively, OR 0.30; 95%CI [0.14: 0.66]; I<sup>2</sup> = 0%; p = 0.003 and OR 0.13; 95%CI [0.03: 0.57]; I<sup>2</sup> = 0%; p = 0.007). Conservative bowel procedures are associated with lower rates of persistent post-operative voiding dysfunction and should be considered first when possible.Trial registration: Our meta-analysis was registered under the PROSPERO number: CRD42023395356.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Updates in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13304-025-02124-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

To define the risk factors of post-operative voiding dysfunction according to the type of surgical procedure performed. A systematic review through PubMed, the Cochrane Library, and Web of Science databases was performed. The Medical Subject Headings terms aimed for English articles about colorectal endometriosis surgery and voiding dysfunction published until December 26, 2022 were used. The primary outcome was the occurrence of post-operative voiding dysfunction. Secondary outcome was the presence of a persistent voiding dysfunction at 1 month. MeSH terms included ''deep endometriosis'', ''surgery'', or ''voiding dysfunction''. Two reviewers (AM, PE) assessed the quality of each article independently. A Study Quality Assessment Tool was used to provide rating of the quality of the included studies. 22 studies were included in the final analysis. Rectal shaving was associated with less voiding dysfunction than segmental resection (OR 0.33; 95%CI [0.20: 0.54]; I2 = 0%; p < 10-3). No difference was found between rectal shaving and discoid excision (OR 0.44; 95%CI [0.07: 2.84]; I2 = 55%; p = 0.39), nor between discoid excision and segmental resection (OR 0.44; 95%CI [0.18: 1.09]; I2 = 49%; p = 0.08). Conservative surgery (i.e., shaving and discoid) was associated with less voiding dysfunction than radical surgery (i.e., segmental resection) (OR 0.37; 95%CI [0.25: 0.55]; I2 = 0%; p < 10-3). Regarding persistent voiding dysfunction, rectal shaving and discoid excision were less associated with voiding dysfunction than segmental resection (respectively, OR 0.30; 95%CI [0.14: 0.66]; I2 = 0%; p = 0.003 and OR 0.13; 95%CI [0.03: 0.57]; I2 = 0%; p = 0.007). Conservative bowel procedures are associated with lower rates of persistent post-operative voiding dysfunction and should be considered first when possible.Trial registration: Our meta-analysis was registered under the PROSPERO number: CRD42023395356.

结直肠深浸润性子宫内膜异位症术后排尿功能障碍:最新的系统综述和荟萃分析。
目的:根据手术方式确定术后排尿功能障碍的危险因素。通过PubMed、Cochrane图书馆和Web of Science数据库进行系统评价。使用截至2022年12月26日发表的关于结直肠子宫内膜异位症手术和排尿功能障碍的英文文章的医学主题标题术语。主要观察指标为术后排尿功能障碍的发生情况。次要结果是1个月时出现持续的排尿功能障碍。MeSH术语包括“深部子宫内膜异位症”、“手术”或“排尿功能障碍”。两位审稿人(AM, PE)独立评估每篇文章的质量。使用研究质量评估工具对纳入研究的质量进行评级。22项研究被纳入最终分析。与节段性切除相比,直肠剃须与较少的排尿功能障碍相关(OR 0.33;95%ci [0.20: 0.54];i2 = 0%;3页)。直肠剃须和椎间盘切除之间没有差异(OR 0.44;95%ci [0.07: 2.84];i2 = 55%;p = 0.39),盘状切除术和节段性切除术之间也没有差异(OR 0.44;95%ci [0.18: 1.09];i2 = 49%;p = 0.08)。保守手术(如剃须和椎间盘)与根治性手术(如节段性切除)相比,较少出现排尿功能障碍(OR 0.37;95%ci [0.25: 0.55];i2 = 0%;3页)。对于持续的排尿功能障碍,直肠剃须和椎间盘切除术与排尿功能障碍的相关性低于节段性切除术(分别OR 0.30;95%ci [0.14: 0.66];i2 = 0%;p = 0.003, OR = 0.13;95%ci [0.03: 0.57];i2 = 0%;p = 0.007)。保守的肠道手术与术后持续排尿功能障碍的发生率较低相关,应在可能的情况下首先考虑。试验注册:我们的meta分析注册在PROSPERO号下:CRD42023395356。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信