Yang Lilin, Gao Jie, Zeng Lei, Weng Zhiwei, Luo Songping
First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Gynecology, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
Int J Gynaecol Obstet. 2016 Apr;133(1):9-16. doi: 10.1016/j.ijgo.2015.08.013. Epub 2015 Dec 15.
The choice between single-port laparoscopic hysterectomy (SPLH) and conventional laparoscopic hysterectomy (CLH) remains unclear.
To evaluate the feasibility, safety, and comparative effectiveness of SPLH and CLH.
PubMed, Web of Science, and the Cochrane Library were searched in February 2015 using combinations of the terms "single port," "single incision," "single site," "laparoscopic hysterectomy," and "laparoendoscopic hysterectomy."
Randomized controlled trials (RCTs) and retrospective studies comparing SPLH and CLH were included if they reported at least one quantitative outcome.
Study characteristics, quality, and outcomes were assessed. The primary outcomes were procedure failure and perioperative complications. Odds ratio (ORs) and 95% confidence intervals (CIs) were calculated.
Eighteen studies (6 RCTs, 12 retrospective studies) were included. As compared with CLH, SPLH had a higher failure rate (OR 6.37, 95% CI 3.34-12.14; P<0.001). The frequency of perioperative complications did not differ (OR 0.89, 95% CI 0.45-1.74; P=0.73).
There is no significant difference in the frequency of perioperative complications between SPLH and CLH. However, the higher rate of procedure failure in SPLH should be taken into consideration.
单孔腹腔镜子宫切除术（SPLH）与传统腹腔镜子宫切除术（CLH）之间的选择仍不明确。
评估SPLH和CLH的可行性、安全性及比较效果。
2015年2月在PubMed、科学网和考克兰图书馆进行检索，使用“单孔”“单切口”“单部位”“腹腔镜子宫切除术”和“腹腔镜内镜下子宫切除术”等术语组合。
纳入比较SPLH和CLH的随机对照试验（RCT）和回顾性研究，若其报告至少一项定量结果。
评估研究特征、质量和结果。主要结果为手术失败和围手术期并发症。计算比值比（OR）和95%置信区间（CI）。
纳入18项研究（6项RCT，12项回顾性研究）。与CLH相比，SPLH的失败率更高（OR 6.37，95%CI 3.34 - 12.14；P<0.001）。围手术期并发症的发生率无差异（OR 0.89，95%CI 0.45 - 1.74；P = 0.73）。
SPLH和CLH围手术期并发症的发生率无显著差异。然而，应考虑SPLH较高的手术失败率。
