Comparison of single-site to multi-port laparoscopic hysterectomy in patients with benign or malignant gynecological diseases: A meta-analysis of 3309 patients.

BACKGROUND

This meta-analysis evaluates the benefits of single-site laparoscopy hysterectomy (SS-LH) compared to conventional multi-port laparoscopy (MP-LH). Although SS-LH offers cosmetic and less invasive advantages, the efficacy and safety results in existing studies remain inconsistent.

OBJECTIVE

We aimed to compare the outcomes of SS-LH and MP-LH in patients with benign and malignant gynecological diseases, focusing on the benefits of each modality.

METHODS

Following PRISMA guidelines, we conducted searches in PubMed, Cochrane CENTRAL, and Embase for randomized controlled trials (RCTs) and cohort studies up to March 5, 2024. We included studies comparing SS-LH and MP-LH, analyzing outcomes like complications, bleeding volume, operative time, length of stay, uterus weight, conversion rate, postoperative pain, fever, port site infection, and port hernia.

RESULTS

The analysis included 3309 patients. SS-LH was associated with fewer complications (RR=0.46, p = 0.0005) and shorter operative time (MD=13.70 min , p = 0.02). No significant differences were found for blood loss, length of stay, uterus weight, conversion rate, postoperative pain, fever, port site infection, or port hernia.

CONCLUSION

SS-LH demonstrates lower complication rates and shorter operative time compared to MP-LH. Both procedures are safe and effective, but larger multicentric randomized trials are needed to establish SS-LH as the standard of care.