Identifying the superior surgical procedure for endometrial polypectomy: A network meta-analysis

Area of Science:

• Gynecology
• Surgical Innovation
• Evidence-Based Medicine

Background:

• Endometrial polyps are common gynecological issues requiring surgical intervention.
• Various surgical techniques exist for endometrial polypectomy, each with distinct clinical outcomes.
• A comparative analysis is needed to determine the optimal surgical approach.

Purpose of the Study:

• To conduct a network meta-analysis comparing different surgical procedures for endometrial polypectomy.
• To identify the most effective surgical method based on operative time, success rates, and complication profiles.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, and Cochrane Central for randomized controlled trials (RCTs).
• Bayesian network meta-analysis to quantitatively pool surgical outcomes (operative time, success, complications).
• Surface Under the Cumulative Ranking (SUCRA) probabilities used for ranking procedures; node-splitting and funnel plots assessed for bias.

Main Results:

• Eight RCTs involving five distinct procedures were analyzed.
• Hysteroscopic morcellation demonstrated the highest likelihood of superior clinical effects across operative time (SUCRA 0.49), success rate (SUCRA 0.90), and complications (SUCRA 0.50).
• No significant inconsistency or publication bias was detected.

Conclusions:

• Hysteroscopic morcellation emerges as a potentially superior surgical option for endometrial polypectomy.
• High-quality, large-scale trials are warranted to validate these findings.
• Future research should encompass a broader range of emerging surgical techniques.