ABSTRACT
OBJECTIVE: To assess bowel function in women with deep infiltrating endometriosis according to surgical approach (radical vs conservative). DATA SOURCES: Five databases were searched from 1970 to September 2021 to retrieve studies comparing radical (colorectal segmental resection) and conservative (shaving or discoid excision) surgery for bowel function in women with deep infiltrating endometriosis. METHODS OF STUDY SELECTION: No language restriction was applied. Two reviewers extracted and combined data from the included studies, applying a meta-analytic model with random effects in all calculations. Results are expressed in risk ratio (RR) with 95% confidence interval (CI). Assessment of risk of bias and quality of evidence was performed by the Newcastle-Ottawa and Grading of Recommendations, Assessment, Development and Evaluation, respectively. TABULATION, INTEGRATION, AND RESULTS: We included 13 studies in our meta-analysis, and most of them were of nonrandomized design. Conservative surgery had fewer events of constipation and frequent bowel movements when compared with radical surgery (RR, 2.31; 95% CI, 1.21-4.43; I2 = 0%; 3 studies; RR, 2.80; 95% CI 1.17-6.75; I2 = 0%; 2 studies, respectively). Defecation pain, anal incontinence loss, minor and major lower anterior resection syndrome, and Clavien-Dindo complications grade I to IV showed no statistically significant difference between surgeries. Grading of Recommendations, Assessment, Development and Evaluation assessment was low to very low for all outcomes. CONCLUSION: Conservative surgery (shaving or discoid excision) presented fewer events of constipation and frequent bowel movements than colorectal segmental resection. There was a very low quality of evidence to provide recommendations regarding bowel function.
Subject(s)
Colorectal Neoplasms , Digestive System Surgical Procedures , Endometriosis , Rectal Diseases , Female , Humans , Rectal Diseases/surgery , Rectal Diseases/complications , Endometriosis/complications , Endometriosis/surgery , Digestive System Surgical Procedures/methods , Defecation , Treatment Outcome , Postoperative Complications/etiology , Constipation/etiology , Colorectal Neoplasms/complicationsSubject(s)
Gynecologic Surgical Procedures , Perioperative Care , Female , Humans , Postoperative ComplicationsSubject(s)
Humans , Female , Gynecologic Surgical Procedures/methods , Enhanced Recovery After Surgery/standards , Perioperative Medicine/methods , Perioperative Medicine/standards , Pain, Postoperative/prevention & control , Postoperative Complications/prevention & control , Body Temperature Regulation , Drainage/standards , Fasting , Practice Guideline , Evidence-Based Medicine/methods , Postoperative Nausea and Vomiting/prevention & control , Dehydration/prevention & control , Diet Therapy , Ileal Diseases/prevention & control , Anesthesia/standardsABSTRACT
It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. However, some women need treatment for various gynecological diseases that cannot be postponed. The purpose of this article is to present recommendations on surgical treatment during the COVID-19 pandemic.
Estima-se que cerca de 28 milhões de cirurgias sejam postergadas ou canceladas no mundo em decorrência desta pandemia, causando atraso no diagnóstico e tratamento de mais de 2 milhões de casos oncológicos. No Brasil, tanto a ANS (Agencia Nacional de Saúde) como a ANVISA (Agencia Nacional de Vigilância Sanitária) orientaram o adiamento das cirurgias eletivas e não essenciais, tendo um impacto considerável no número de procedimentos cirúrgicos com diminuição de 33,4% neste período no Brasil. No entanto, algumas mulheres necessitam de tratamento para várias doenças ginecológicas, algumas das quais não podem ser adiadas. O objetivo deste artigo é apresentar recomendações sobre o tratamento cirúrgico durante a pandemia de COVID-19.
Subject(s)
Coronavirus Infections/epidemiology , Gynecologic Surgical Procedures , Pandemics , Patient Care Planning , Pneumonia, Viral/epidemiology , Betacoronavirus , Brazil/epidemiology , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Elective Surgical Procedures/statistics & numerical data , Female , Gynecologic Surgical Procedures/statistics & numerical data , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Risk Factors , SARS-CoV-2ABSTRACT
Abstract It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. However, some women need treatment for various gynecological diseases that cannot be postponed. The purpose of this article is to present recommendations on surgical treatment during the COVID-19 pandemic.
Resumo Estima-se que cerca de 28 milhões de cirurgias sejam postergadas ou canceladas nomundo em decorrência desta pandemia, causando atraso no diagnóstico e tratamento de mais de 2 milhões de casos oncológicos. No Brasil, tanto a ANS (Agencia Nacional de Saúde) comoa ANVISA (Agencia Nacional de Vigilância Sanitária) orientaram o adiamento das cirurgias eletivas e não essenciais, tendo um impacto considerável no número de procedimentos cirúrgicos comdiminuição de 33,4% neste período no Brasil.No entanto, algumasmulheres necessitam de tratamento para várias doenças ginecológicas, algumas das quais não podem ser adiadas. O objetivo deste artigo é apresentar recomendações sobre o tratamento cirúrgico durante a pandemia de COVID-19.
Subject(s)
Humans , Female , Patient Care Planning , Pneumonia, Viral/epidemiology , Gynecologic Surgical Procedures/statistics & numerical data , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Brazil/epidemiology , Cross Infection/prevention & control , Risk Factors , Elective Surgical Procedures/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Disease Transmission, Infectious/prevention & control , Betacoronavirus , SARS-CoV-2 , COVID-19ABSTRACT
Estima-se que cerca de 28 milhões de cirurgias sejam postergadas ou canceladas no mundo em decorrência desta pandemia, causando atraso no diagnóstico e tratamento de mais de 2 milhões de casos oncológicos. No Brasil, tanto a ANS (Agência Nacional de Saúde) como a Anvisa (Agência Nacional de Vigilância Sanitária) orientaram o adiamento das cirurgias eletivas e não essenciais, tendo um impacto considerável no número de procedimentos cirúrgicos, com diminuição de 33,4% neste período no Brasil. No entanto, algumas mulheres necessitam de tratamento para várias doenças ginecológicas, algumas das quais não podem ser adiadas. O objetivo deste artigo é apresentar recomendações sobre o tratamento cirúrgico durante a pandemia de COVID-19.(AU)
