Total laparoscopic hysterectomy versus vaginal hysterectomy: a systematic review and meta-analysis

Publication date: Available online 17 November 2016 Source:Journal of Minimally Invasive Gynecology Author(s): E.M. Sandberg, A.R.H. Twijnstra, S.R.C. Driessen, F.W. Jansen Hysterectomies performed laparoscopically have greatly increased within the last few decades and even exceed the number of vaginal hysterectomies (VH). This systematic review compares surgical outcomes of total laparoscopic hysterectomy (TLH) and VH to evaluate which approach offers the most benefits and was conducted according to the Meta-analysis of Observational Studies in Epidemiology guidelines. A literature search was performed in PubMed, Embase, Web of Science for all relevant publications from January 2000 through February 2016. All randomized controlled trials and cohort studies for benign indication or low-grade malignancy comparing TLH to VH were considered for inclusion. From the literature search, 24 articles were found relevant and included in this review. The results of our meta-analysis showed no difference between the two groups for overall complications (Odds ratio (OR) 1.24 [0.68, 2.28] for major complications, OR 0.83 [0.53, 1.28] for minor complications), risk of ureter and bladder injuries (OR 0.81 [0.34, 1.92]), intraoperative blood loss (MD -30 mL [-67.34, 7.60]), length of hospital stay (-0.61 days [-1.23, -0.01]), VH was associated with a shorter operative time (MD 42 min [29.34, 55.91]), a lower rate of vaginal cuff dehiscence (OR 6.28 [2.38, 16.57]), and conversion to lapa...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research