Stefano Angioni1, Alessandro Pontis2, Adolfo Pisanu2, Liliana Mereu3, Horace Roman4. 1. Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: sangioni@yahoo.it. 2. Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. 3. Department of Obstetrics and Gynaecology, Hospital Santa Maria Chiara, Trento, Italy. 4. Department of Obstetrics and Gynaecology, University of Rouen, Rouen, France.
Abstract
STUDY OBJECTIVE: The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH). DESIGN: Case-control study. Canadian Task Force Classification II-2. SETTING: The study was conducted at university hospitals in Cagliari, Italy, and Rouen, France. PATIENTS: Sixty-one women with metrorrhagia, abnormal uterine bleeding with uterine myomas, or symptomatic adenomyosis were included in the study. INTERVENTIONS: Thirty-one patients underwent SPAL-SH, and 30 patients underwent conventional MPAL-SH. MEASUREMENTS AND MAIN RESULTS: We analyzed the data to compare the outcomes of SPAL-SH versus MPAL-SH. Patients in the SPAL-SH group had longer operative times than those in the MPAL-SH group (p < .001) but shorter hospital stays (p < .001). Postoperative pain immediately after surgery, after 6 hours, and after 24 hours were lower in the SPAL-SH group (p < .001). The SPAL-SH group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01). CONCLUSION: We conclude that SPAL-SH is a feasible and safe alternative to standard MPAL-SH in selected patients. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. In addition, SPAL-SH has a definite benefit in relation to body image and cosmesis.
STUDY OBJECTIVE: The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH). DESIGN: Case-control study. Canadian Task Force Classification II-2. SETTING: The study was conducted at university hospitals in Cagliari, Italy, and Rouen, France. PATIENTS: Sixty-one women with metrorrhagia, abnormal uterine bleeding with uterine myomas, or symptomatic adenomyosis were included in the study. INTERVENTIONS: Thirty-one patients underwent SPAL-SH, and 30 patients underwent conventional MPAL-SH. MEASUREMENTS AND MAIN RESULTS: We analyzed the data to compare the outcomes of SPAL-SH versus MPAL-SH. Patients in the SPAL-SH group had longer operative times than those in the MPAL-SH group (p < .001) but shorter hospital stays (p < .001). Postoperative pain immediately after surgery, after 6 hours, and after 24 hours were lower in the SPAL-SH group (p < .001). The SPAL-SH group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01). CONCLUSION: We conclude that SPAL-SH is a feasible and safe alternative to standard MPAL-SH in selected patients. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. In addition, SPAL-SH has a definite benefit in relation to body image and cosmesis.
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