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单孔腹腔镜与传统腹腔镜治疗子宫肌瘤的疗效比较:一项最新的荟萃分析。

Comparison of efficacy of single-port versus conventional laparoscopic treatment for uterine leiomyoma: a latest meta-analysis.

作者信息

Li Yanhui, Liu Rui, Li Xue

机构信息

Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Department of Obstetrics and Gynecology, Dezhou United Hospital, Dezhou, Shandong, China.

出版信息

Front Oncol. 2023 Aug 2;13:1192582. doi: 10.3389/fonc.2023.1192582. eCollection 2023.

Abstract

OBJECTIVE

Single-port laparoscopy has been proposed as an ideal surgical method for the treatment of uterine leiomyoma. It can effectively remove the lesion, reduce the loss of hemoglobin, and has superior cosmetic effects. Therefore, we searched relevant studies and conducted a meta-analysis to evaluate the effect of single-port laparoscopy on myoma resection, hemoglobin loss, and scar beauty compared to conventional laparoscopy.

METHODS

We systematically searched PubMed, EMBASE, scope, Cochrane, CNKI, and other databases to find randomized controlled studies on the efficacy of single-port laparoscopy and traditional laparoscopy for meta-analysis. The main outcomes of our study were the duration of surgery, the reduction of hemoglobin, and the cosmetic effect of the postoperative scar. The effect model was selected according to heterogeneity (random effect model or fixed effect model), and the relevant sensitivity analysis and publication bias test were performed.

RESULTS

We searched a total of 501 related literature articles and finally included 19 studies involving 21 researchers. Comparison of single-port laparoscopic myomectomy with traditional surgery: Operation time had no significant difference (Standardized Mean Difference [SMD]: 0.13, 95% Confidence interval (CI), -0.04 to 0.30; I²=74%; P = 0.14); The reduction of hemoglobin is lower ([SMD]: -0.04; 95% CI, -0.23 to 0.14; I²=71%; P = 0.65), and the cosmetic effect of postoperative scar is more satisfactory ([SMD]: 0.42, 95% CI: 0.02 to 0.83; I²=72%, P= 0.04). There was no significant difference in conversion rate, postoperative pain, blood loss, postoperative gastrointestinal recovery time, or length of hospital stay.

CONCLUSION

Compared with traditional laparoscopy, the operation time of the treatment of uterine leiomyoma by single-port laparoscopy is not extended, the reduction of hemoglobin is less, and the cosmetic effect of the scar is better. Therefore, single-port laparoscopy is superior to traditional surgery in the treatment of uterine leiomyoma.

SYSTEMATIC REVIEW REGISTRATION

https://inplasy.com/inplasy-2023-3-0071/, identifier INPLASY202330071.

摘要

目的

单孔腹腔镜已被提议作为治疗子宫肌瘤的理想手术方法。它能有效切除病灶,减少血红蛋白丢失,且具有卓越的美容效果。因此,我们检索了相关研究并进行荟萃分析,以评估与传统腹腔镜相比,单孔腹腔镜在肌瘤切除、血红蛋白丢失及瘢痕美观方面的效果。

方法

我们系统检索了PubMed、EMBASE、scope、Cochrane、CNKI等数据库,以查找关于单孔腹腔镜与传统腹腔镜疗效的随机对照研究进行荟萃分析。我们研究的主要结局指标为手术时长、血红蛋白降低情况及术后瘢痕的美容效果。根据异质性选择效应模型(随机效应模型或固定效应模型),并进行相关敏感性分析和发表偏倚检验。

结果

我们共检索到501篇相关文献,最终纳入19项研究,涉及21位研究者。单孔腹腔镜子宫肌瘤切除术与传统手术的比较:手术时间无显著差异(标准化均数差[SMD]:0.13,95%置信区间[CI],-0.04至0.30;I² = 74%;P = 0.14);血红蛋白降低幅度更小([SMD]:-0.04;95% CI,-0.23至0.14;I² = 71%;P = 0.65),术后瘢痕的美容效果更令人满意([SMD]:0.42,95% CI:0.02至0.83;I² = 72%,P = 0.04)。在转化率、术后疼痛、失血量、术后胃肠道恢复时间或住院时长方面无显著差异。

结论

与传统腹腔镜相比,单孔腹腔镜治疗子宫肌瘤的手术时间未延长,血红蛋白降低幅度更小,瘢痕的美容效果更好。因此,单孔腹腔镜在子宫肌瘤治疗方面优于传统手术。

系统评价注册

https://inplasy.com/inplasy-2023-3-0071/,标识符INPLASY202330071。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6de7/10433900/be6b53c08473/fonc-13-1192582-g002.jpg

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