The Comparison Of Single-port And Robotic-assisted Vs Conventional Laparoscopes For Hysterectomy:a Meta-analysis

Objective:The aim of this meta-analysis was to compare the safety and efficacy of single-port and robotic-assisted laparoscopy versus conventional laparoscopy about hysterectomy in denign disease?Methods:Literature searches of electronic databases including Embase,Cochrane library,major medical magazine's website and CNKI,were comprehensively searched,and searching the relevant literatures in Pubmed,google scholar and sci-hub.Relevant outcome measures of efficacy and safety were then analyzed by using Revman software(version 5.3)that is provided by the Cochrane Community.Results: In all,12 RCTS(7 about single-port,5 about robotic)with 1182 patients were included in this meta-analysis.342 patients received single-port laparoscopy,258 patients received robotic treatment,while 584 patients were treated with conventional laparoscopic approach.The meta-analysis results showed that there were no significant difference between the single-port laparoscopy and conventional laparoscopy in terms of intraoperative complication rate(RR=1.07,95%CI [0.16,7.25],p=0.95),postoperative complication rate(RR=1.09,95%CI [0.51,2.34],p=0.82),length of hospital stay(WMD=-0.09,95%CI [-0.26,0.07],p=0.27),conversion rate(RR=2.44,95%CI [0.86,6.87],p=0.09),operative blood loss(WMD=-5.21,95%CI [-20.61,10.19],p=0.51)and postoperative pain(WMD=-0.42,95%CI [-0.99,0.15],p=0.15).However,single port laparoscopy group significantly increased operation time(WMD=13.13,95%CI [1.69,24.56],p=0.02),while significantly decreased gastrointestinal function recovery time(WMD=-1.69,95%CI [-3.11,-0.27],p=0.02).There were no significant differences between the robotic-assisted laparoscopy and conventional laparoscopy in intraoperative complication rate(p=0.31),postoperative complication rate(p=0.14),conversion rate(P=0.79),operative time(P=0.47)and length of hospital stay(P=0.48).Conclusion: Hysterectomy for benign gynecologic conditions,compared to the conventional laparoscopy,the single-port and robotic-assisted laparoscopy were both safe and feasible,but did not show a superior advantage over conventional laparoscopy.