Xie Weimin, Wang Zhangyi, Liu Xiaohang, Tan Songhong
Department of Gynecology, Affiliated Hengyang Hospital of Hunan Normal University & Hengyang Central Hospital, Hunan Province, No. 31 Guanghui Road, Zhengxiang District, Hengyang City, 421000, China.
Nursing Department, Affiliated Hengyang Hospital of Hunan Normal University & Hengyang Central Hospital, Hunan Province, Hengyang, 421000, China.
BMC Cancer. 2025 Mar 27;25(1):554. doi: 10.1186/s12885-025-13968-6.
This meta-analysis aims to compare the safety and efficacy of robotic single-site hysterectomy (RSSH) with robotic multiport hysterectomy (RMPH) in treating endometrial cancer.
We conducted a comprehensive literature search across several databases, including PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, the Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Chinese Science and Technology Journal Full Text Database (VIP). The search covered literature from inception until October 17, 2024. The primary outcomes included intraoperative complications, postoperative complications, postoperative pain scores, and satisfaction with cosmetic outcomes. The secondary outcomes included operative time (min), estimated blood loss (ml), hemoglobin drop, blood transfusion, conversion, postoperative hospital stay, lymph nodes harvested, sentinel lymph node identification, recurrence, and mortality during follow-up. Data analysis was performed using random-effects or fixed-effects models, calculating combined risk ratios (RR), weighted mean difference (WMD), and 95% confidence intervals (95% CI).
Five studies describing a total of 448 patients were retained and included for this meta-analysis. No significant differences were found between RSSH and RMPH regarding intraoperative complications, postoperative complications, and postoperative pain scores. There were also no differences in terms of operation time, estimated blood loss, hemoglobin drop, blood transfusion, conversion, postoperative hospital stay, lymph nodes harvested, and sentinel lymph node identification.
This systematic review and meta-analysis provides evidence that RSSH is effective and safe for the treatment of endometrial cancer, as it is generally equivalent to RMPH regarding perioperative outcomes.
本荟萃分析旨在比较机器人单孔腹腔镜子宫切除术（RSSH）与机器人多孔腹腔镜子宫切除术（RMPH）治疗子宫内膜癌的安全性和有效性。
我们在多个数据库中进行了全面的文献检索，包括PubMed、Cochrane对照试验中央注册库（CENTRAL）、Embase、中国知网（CNKI）、万方和中国科技期刊全文数据库（VIP）。检索涵盖了从数据库建立至2024年10月17日的文献。主要结局包括术中并发症、术后并发症、术后疼痛评分和对美容效果的满意度。次要结局包括手术时间（分钟）、估计失血量（毫升）、血红蛋白下降、输血、中转开腹、术后住院时间、获取的淋巴结数量、前哨淋巴结识别、复发以及随访期间的死亡率。使用随机效应或固定效应模型进行数据分析，计算合并风险比（RR）、加权平均差（WMD）和95%置信区间（95%CI）。
五项研究共纳入448例患者，被保留并纳入本荟萃分析。RSSH和RMPH在术中并发症、术后并发症和术后疼痛评分方面未发现显著差异。在手术时间、估计失血量、血红蛋白下降、输血、中转开腹、术后住院时间、获取的淋巴结数量和前哨淋巴结识别方面也没有差异。
本系统评价和荟萃分析提供了证据，表明RSSH治疗子宫内膜癌是有效且安全的，因为其围手术期结局总体上与RMPH相当。
