PONE-D-22-21731

Complications following surgeries for endometriosis: a systematic review protocol

PLOS ONE

Dear Dr. Boutin,

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Partly

Reviewer #2: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Complications after endometriosis surgery is a very important topic and any attempt to analyze their frequency and determinants is welcome. In this manuscript, authors present a protocol for studying complications rates following each type of surgeries for endometriosis and determinants of those complications.

There are several pitfalls that must be addressed before accepting it for publication:

1.- In the Search Strategy section, only 3 databases are included: MEDLINE (via PubMed), EMBASE, and the Cochrane Library. However other important electronic databases (such as Web of Science, Wanfang data, ClinicalTrials, NLM Gateway, Google Scholar, or BIOSIS preview) may give also important information. The authors should explain why them are not searching those database.

2.- As the review wi bell reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis format, the inclusion criteria should be sufficiently followed by PICOS (P: participants, I: intervention, C: comparison, O: outcomes, S: study design) format.

3.- The Cochrane Collaboration is more suitable for randomized controlled trials, and it is expected that all the included studies will be nonrandomized controlled trials [3]. Therefore, Downs and Black Tools (27 items with a total score of 29) are recommended for authors (SH Downs, N. Black. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health: 1998; 52, 377-384)

4.-The authors should clarify and more clearly define some of the terms they will use to explain characteristics of the study, the participants, and the potential determinants of complications. For example, how they will define or classify “symptoms”: will it be pain? severity of pain? intestinal or urinary symptoms? infertility?. How they will define “severity of endometriosis”? by using ASRM classification? If yes, it is well known that this classification has a bad correlation with surgical complications. If they opt by using ENZIAN classification, how they will built the final ENZIAN score?. Finally, although other definitions should be also provided, one the most important missing definition is the core of this protocol: how the author will define “surgical complication” and how they will define “major and minor complications”?. Other important missing definitions are how they will define “level care of centers”, “expertise of the surgery team”… Furthermore, the authors should explain why they are not taking in account other confounding factors as the association with adenomyosis is or if they will consider as a complication of endometriosis surgery the impairment of ovarian function frequently seen after ovarian endometrioma stripping.

Reviewer #2: Dear

Thank you to giving me the chance to review this interesting protocol on a very important topic

for the management of endometriosis

In order to explain better to the readers the importance of some important factors influencing iatrogenic complications (ie ureteral stent, parametrial or vaginal mucosa

Involvement) related to deep infiltrating endometriosis surgery I suggest to include and briefly comments some relevant articles (eg doi 10.1002/ijgo.14089, 10.1002/ijgo.13959, 10.1111/aogs.13824).

I believe that is important to list exauatively all complications that will be assessed, both de novo functional than organic ones.

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Reviewer #1: No

Reviewer #2: No

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Complications following surgeries for endometriosis: a systematic review protocol

PONE-D-22-21731R1

Dear Dr. Boutin,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Diego Raimondo

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The questions raised by this reviewer have been answered and the paper is now worthy of publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

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