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

BackgroundThe choice between single-port laparoscopic hysterectomy (SPLH) and conventional laparoscopic hysterectomy (CLH) remains unclear.ObjectivesTo evaluate the feasibility, safety, and comparative effectiveness of SPLH and CLH.Search strategyPubMed, 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 criteriaRandomized controlled trials (RCTs) and retrospective studies comparing SPLH and CLH were included if they reported at least one quantitative outcome.Data collection and analysisStudy 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 resultsEighteen 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).ConclusionsThere 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.