Uterine artery embolization versus surgical treatment in patients with symptomatic uterine fibroids: Protocol for a systematic review and meta-analysis of individual participant data.

Autor: Middelkoop MA; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. Electronic address: m.middelkoop@vumc.nl., Harmsen MJ; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands., Manyonda I; Department of Obstetrics and Gynaecology, St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, United Kingdom., Mara M; Department of Obstetrics and Gynaecology, Division of Minimally Invasive Surgery, General Faculty Hospital and 1st Medical Faculty of Charles University, Apolinarska 18, 128 00, Prague 2, Czech Republic., Ruuskanen A; Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland., Daniels J; Nottingham Clinical Trials Unit, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom., Mol BWJ; Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia., Moss J; Department of Interventional Radiology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, United Kingdom., Hehenkamp WJK; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands., Wu O; Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, United Kingdom.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2021 Jan; Vol. 256, pp. 179-183. Date of Electronic Publication: 2020 Nov 11.
DOI: 10.1016/j.ejogrb.2020.11.027
Abstrakt: Objective: Uterine fibroids are the most common benign tumours in women of the reproductive age. Symptoms of heavy menstrual bleeding, abdominal discomfort and infertility may seriously affect a woman's quality of life. Uterine artery embolization is a safe and effective alternative treatment to hysterectomy or myomectomy for symptomatic uterine fibroids. Which treatment provides the highest quality of life, least complications, symptom reduction and least chance intervention, has not been established and might depend on strict patient selection. This study aims to identify which specific subgroups benefit most of each treatment by analyzing individual participant data derived from randomized controlled trials of women undergoing embolization or surgical treatment. This study will primarily assess the effectiveness of both treatment groups by evaluating the effect on quality of life of embolization in comparison to surgery on specific patient and fibroid characteristics and the possible need for re-intervention for fibroid-related symptoms.
Data Sources: PubMed/MEDLINE, Embase and The Cochrane Library were searched up to August 2020.
Study Eligibility Criteria: We will collect individual participant data from randomized controlled trials that studied clinical and procedural outcomes of premenopausal women with symptomatic uterine fibroids, who were randomized between uterine artery embolization and surgery.
Study Appraisal and Synthesis Methods: Individual participant data from all eligible trials will be sought and analysed according to intention-to-treat principle. Risk of Bias will be done by using version 2 of the Cochrane tool for Risk of Bias in randomized trials. Subgroup analyses to explore the effect of e.g. age, fibroid characteristics and fibroid complaints will be performed, if data is available. This individual patient data meta-analysis will be analysed according to a one-stage model.
Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare.
(Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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