Comparison of single-site to multi-port laparoscopic hysterectomy in patients with benign or malignant gynecological diseases: A meta-analysis of 3309 patients.

Background: This meta-analysis evaluates the benefits of single-site laparoscopy hysterectomy (SS-LH) compared to conventional multi-port laparoscopy (MP-LH). Although SS-LH offers cosmetic and less invasive advantages, the efficacy and safety results in existing studies remain inconsistent.

Objective: We aimed to compare the outcomes of SS-LH and MP-LH in patients with benign and malignant gynecological diseases, focusing on the benefits of each modality.

Methods: Following PRISMA guidelines, we conducted searches in PubMed, Cochrane CENTRAL, and Embase for randomized controlled trials (RCTs) and cohort studies up to March 5, 2024. We included studies comparing SS-LH and MP-LH, analyzing outcomes like complications, bleeding volume, operative time, length of stay, uterus weight, conversion rate, postoperative pain, fever, port site infection, and port hernia.

Results: The analysis included 3309 patients. SS-LH was associated with fewer complications (RR=0.46, p = 0.0005) and shorter operative time (MD=13.70 min , p = 0.02). No significant differences were found for blood loss, length of stay, uterus weight, conversion rate, postoperative pain, fever, port site infection, or port hernia.

Conclusion: SS-LH demonstrates lower complication rates and shorter operative time compared to MP-LH. Both procedures are safe and effective, but larger multicentric randomized trials are needed to establish SS-LH as the standard of care.