Tae-Joong Kim1, So-Jin Shin2, Tae-Hyun Kim1, Chi-Heum Cho3, Sang-Hoon Kwon2, Seok Ju Seong4, SeokJu Sung, Taejong Song4, Sooyoung Hur5, Yong-Man Kim6, Shin-Wha Lee6, Young Tae Kim7, Eun Ji Nam7, Yong Beom Kim8, Jung Ryeol Lee8, Hyun-Jin Roh9, Hyewon Chung2. 1. Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Keimyung University School of Medicine, Daegu, Korea. 3. Keimyung University School of Medicine, Daegu, Korea. Electronic address: chcho@kmu.ac.kr. 4. CHA Gangnam Medical Center, CHA University, Seoul, Korea. 5. The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea. 6. University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 7. Yonsei University College of Medicine, Severance Medical Center, Seoul, Korea. 8. Seoul National University Bundang Hospital, Seongnam, Korea. 9. College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Korea.
Abstract
STUDY OBJECTIVE: To compare the operative outcomes of patients undergoing eithersingle-port or multiport laparoscopic hysterectomy (LH). METHODS:Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar. RESULTS:Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay. CONCLUSION: Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.
RCT Entities:
STUDY OBJECTIVE: To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH). METHODS: Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar. RESULTS: Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay. CONCLUSION: Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.
Authors: Evelien M Sandberg; Claire F la Chapelle; Marjolein M van den Tweel; Jan W Schoones; Frank Willem Jansen Journal: Arch Gynecol Obstet Date: 2017-03-29 Impact factor: 2.344