Systematic review and meta-analysis of single-port versus conventional laparoscopic hysterectomy.

BACKGROUND

The choice between single-port laparoscopic hysterectomy (SPLH) and conventional laparoscopic hysterectomy (CLH) remains unclear.

OBJECTIVES

To evaluate the feasibility, safety, and comparative effectiveness of SPLH and CLH.

SEARCH STRATEGY

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."

SELECTION CRITERIA

Randomized controlled trials (RCTs) and retrospective studies comparing SPLH and CLH were included if they reported at least one quantitative outcome.

DATA COLLECTION AND ANALYSIS

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.

MAIN RESULTS

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).

CONCLUSIONS

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.