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Review and meta-analysis of prospective randomized controlled trials (RCTs) comparing laparo-endoscopic single site and multiport laparoscopy in gynecologic operative procedures

  • General Gynecology
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Abstract

Purpose

To critically appraise published randomized controlled trials (RCTs) comparing laparo-endoscopic single site (LESS) and multi-port laparoscopic (MPL) in gynecologic operative surgery; the aim was to assess feasibility, safety, and potential benefits of LESS in comparison to MPL.

Methods

A systematic review and meta-analysis of eleven RCTs. Women undergoing operative LESS and MPL gynecologic procedure (hysterectomy, cystectomy, salpingectomy, salpingo-oophorectomy, myomectomy). Outcomes evaluated were as follows: postoperative overall morbidity, postoperative pain evaluation at 6, 12, 24 and 48 h, cosmetic patient satisfaction, conversion rate, body mass index (BMI), operative time, blood loss, hemoglobin drop, postoperative hospital stay.

Results

Eleven RCTs comprising 956 women with gynecologic surgical disease randomized to either LESS (477) or MPL procedures (479) were analyzed systematically. The LESS approach is a surgical procedure with longer operative and better cosmetic results time than MPL but without statistical significance. Operative outcomes, postoperative recovery, postoperative morbidity and patient satisfaction are similar in LESS and MPL.

Conclusion

LESS may be considered an alternative to MPL with comparable feasibility and safety in gynecologic operative procedures. However, it does not offer the expected advantages in terms of postoperative pain and cosmetic satisfaction.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, San Francesco Hospital, Nuoro, Italy

    Alessandro Pontis

  2. Department of Surgical Sciences, Division of Gynecology and Obstetrics, University of Cagliari, S.S. 554, 09042, Monserrato, CA, Italy

    Federica Sedda, Gian Benedetto Melis & Stefano Angioni

  3. Department of Obstetrics and Gynecology, Santa Chiara Hospital, Trento, Italy

    Liliana Mereu

  4. Department of Surgery, Clinica Chirurgica, Blocco G, Azienda Ospedaliero Universitaria, Presidio Policlinico di Monserrato, University of Cagliari, S.S. 554, 09042, Monserrato, CA, Italy

    Mauro Podda & Adolfo Pisanu

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  7. Stefano Angioni
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Corresponding author

Correspondence to Stefano Angioni.

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Conflict of interest

Alessandro Pontis declares that he has no conflict of interest. Federica Sedda declares that she has no conflict of interest. Liliana Mereu declares that she has no conflict of interest. Mauro Podda declares that he has no conflict of interest. Gian Benedetto Melis declares that he has no conflict of interest. Adolfo Pisanu declares that he has no conflict of interest. Stefano Angioni declares that he has no conflict of interest.

Ethical approval

This article analyzes previous published studies and it does not contain any new study with human participants or animals performed by any of the authors.

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Pontis, A., Sedda, F., Mereu, L. et al. Review and meta-analysis of prospective randomized controlled trials (RCTs) comparing laparo-endoscopic single site and multiport laparoscopy in gynecologic operative procedures. Arch Gynecol Obstet 294, 567–577 (2016). https://doi.org/10.1007/s00404-016-4108-8

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  • DOI: https://doi.org/10.1007/s00404-016-4108-8

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