Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis

Tae‐Joong Kim, Tae-Joong Kim, Kim TJ, So-Jin Shin, So‐Jin Shin, Shin SJ, Tae Hyun Kim, Tae-Hyun Kim, Kim TH, Cho CH, Chi‐Heum Cho, Chi-Heum Cho, Kwon SH, Sang-Hoon Kwon, Sang‐Hoon Kwon, Seok Ju Seong, Seong SJ, SeokJu Sung, Taejong Song, Song T, Hur S, Soo Young Hur, Sooyoung Hur, Yong‐Man Kim, Yong-Man Kim, Kim YM, Lee SW, Shin-Wha Lee, Shin‐Wha Lee, Kim YT, Young Tae Kim, Eun Ji Nam, Nam EJ, Kim YB, Yong Beom Kim, Lee JR, Jung Ryeol Lee, Hyun-Jin Roh, Hyun‐Jin Roh, Chung H, Hyewon Chung
Journal of Minimally Invasive Gynecology · 2015 · vol. 22(5) , pp. 785–791 · doi:10.1016/j.jmig.2015.02.022 · PMID:25757810 · W2115248919
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This prospective randomized trial compared single-port versus multiport laparoscopic hysterectomy for uterine myoma or adenomyosis, assessing differences in success rates.

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Abstract

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.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Hysterectomy Hysterectomy Hysterectomy Laparoscopy Laparoscopy Laparoscopy Leiomyoma Uterine Neoplasms Adenomyosis Adenomyosis Adult Adult Female Female Humans Humans Leiomyoma Leiomyoma Middle Aged

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