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Postoperative Pain After Single-Site Versus Multiport Hysterectomy

Authors :
Xiaoming Guan
Kelly Blazek
J. Biba Nijjar
Stephanie Kliethermes
Kausar Ali
C Kliethermes
Source :
JSLS : Journal of the Society of Laparoendoscopic Surgeons
Publication Year :
2017
Publisher :
The Society of Laparoscopic and Robotic Surgeons, 2017.

Abstract

Background and objectives With advances in laparoscopic surgery, the goal of surgeons and patients is to minimize pain to allow for faster recovery and return to normal daily activities. One of these advances is single-site surgery. In this study, we compared postoperative pain in laparoendoscopic single-site surgery (LESS) to that in traditional multiple-incision hysterectomy. Methods Seventy patients were selected for this prospective cohort study, with 35 undergoing multiple-incision and 35 undergoing LESS hysterectomy. All patients were included who were undergoing hysterectomy with the primary surgeon. All multiport hysterectomies were performed laparoscopically. Six patients underwent LESS hysterectomy and 29 underwent robotic single-site surgery (rLESS). Patients recorded pain levels for 3 weeks after surgery on a variety of measures, including overall and incisional pain. Linear mixed effects models for repeated measures were used for all multivariate analyses, with an unstructured covariance matrix accounting for correlation between time points. Results Overall, across all time points, there was an average reduction in pain by 1.26 (SD 0.69) points in the single-site group (P = .06). Days 3 and 14 had a marginally significant reduction in pain (P = .06 and 0.058, respectively). On days 4 and 7 there was a significant reduction in overall pain (P = .04 and .04, respectively). Conclusion Based on the results, it is likely that single-site hysterectomy leads to less postoperative pain and achieves a lower pain score faster than multiport surgery. A randomized control trial is necessary to confirm these results before accepting them in clinical practice.

Details

ISSN :
19383797 and 10868089
Volume :
21
Database :
OpenAIRE
Journal :
JSLS : Journal of the Society of Laparoendoscopic Surgeons
Accession number :
edsair.doi.dedup.....4f1cdc2069468211dc1092bd81ab0588
Full Text :
https://doi.org/10.4293/jsls.2017.00065