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Laparoscopic radical hysterectomy has higher risk of perioperative urologic complication than abdominal radical hysterectomy: a meta-analysis of 38 studies.
- Source :
-
Surgical endoscopy [Surg Endosc] 2020 Apr; Vol. 34 (4), pp. 1509-1521. Date of Electronic Publication: 2020 Jan 17. - Publication Year :
- 2020
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Abstract
- Objective: A meta-analysis was performed to assess risks of intraoperative and postoperative urologic complications in laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH).<br />Methods: We searched Pubmed, EMBASE, and Cochrane library for studies published up to December, 2018. Manual searches of related articles and relevant bibliographies of published studies were also performed. Two researchers independently performed data extraction. Inclusion criteria of studies were: (1) had information of perioperative complications, and (2) had at least ten patients per group.<br />Results: A total of 38 eligible clinical trials were collected. Intraoperative and postoperative urologic complications were reported by 34 studies and 35 studies, respectively. When all studies were pooled, odd ratios (OR) of LRH for the risk of intraoperative urologic complications compared to abdominal radical hysterectomy (ARH) was 1.40 [95% confidence interval (CI) 1.05-1.87]. The OR of LRH for postoperative complication risk compared to ARH was 1.35 [95% CI 1.01-1.80]. However, significant adverse effects of intraoperative urologic complications in LRH were not observed among articles published after 2012 (OR 1.12, 95% CI 0.77-1.62) in cumulative meta-analysis or subgroup analysis. The incidence of bladder injury was statistically higher than that of ureter injury (pā=ā0.001). In subgroup analysis, obesity and laparoscopic type (laparoscopic assisted vaginal radical hysterectomy) were associated with intraoperative urologic complications.<br />Conclusion: LRH is associated with significantly higher risk of intraoperative and postoperative urologic complications than abdominal radical hysterectomy.
- Subjects :
- Adult
Female
Humans
Hysterectomy methods
Intraoperative Complications epidemiology
Intraoperative Complications etiology
Laparoscopy methods
Middle Aged
Postoperative Complications etiology
Treatment Outcome
Urinary Bladder injuries
Urinary Bladder surgery
Urologic Diseases etiology
Abdomen surgery
Hysterectomy adverse effects
Laparoscopy adverse effects
Postoperative Complications epidemiology
Urologic Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 34
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 31953731
- Full Text :
- https://doi.org/10.1007/s00464-020-07366-1