Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis

Abstract Study Objective To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH). Methods Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single...

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Veröffentlicht in:Journal of minimally invasive gynecology 2015-07, Vol.22 (5), p.785-791
Hauptverfasser: Kim, Tae-Joong, MD, Shin, So-Jin, MD, PhD, Kim, Tae-Hyun, MD, Cho, Chi-Heum, MD, PhD, Kwon, Sang-Hoon, MD, PhD, Sung, SeokJu, MD, PhD, Song, Taejong, MD, Hur, Sooyoung, MD, PhD, Kim, Yong-Man, MD, PhD, Lee, Shin-Wha, MD, PhD, Kim, Young Tae, MD, PhD, Nam, Eun Ji, MD, PhD, Kim, Yong Beom, MD, PhD, Lee, Jung Ryeol, MD, PhD, Roh, Hyun-Jin, MD, PhD, Chung, Hyewon, MD
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container_end_page 791
container_issue 5
container_start_page 785
container_title Journal of minimally invasive gynecology
container_volume 22
creator Kim, Tae-Joong, MD
Shin, So-Jin, MD, PhD
Kim, Tae-Hyun, MD
Cho, Chi-Heum, MD, PhD
Kwon, Sang-Hoon, MD, PhD
Sung, SeokJu, MD, PhD
Song, Taejong, MD
Hur, Sooyoung, MD, PhD
Kim, Yong-Man, MD, PhD
Lee, Shin-Wha, MD, PhD
Kim, Young Tae, MD, PhD
Nam, Eun Ji, MD, PhD
Kim, Yong Beom, MD, PhD
Lee, Jung Ryeol, MD, PhD
Roh, Hyun-Jin, MD, PhD
Chung, Hyewon, MD
description Abstract Study Objective To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH). Methods Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar. Results Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay. Conclusion Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.
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Methods Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar. Results Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay. Conclusion Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.</description><identifier>ISSN: 1553-4650</identifier><identifier>EISSN: 1553-4669</identifier><identifier>DOI: 10.1016/j.jmig.2015.02.022</identifier><identifier>PMID: 25757810</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenomyosis - surgery ; Adult ; Female ; Humans ; Hysterectomy - methods ; Laparoendoscopic single-site surgery ; Laparoscopic hysterectomy ; Laparoscopy - methods ; Leiomyoma - surgery ; Middle Aged ; Obstetrics and Gynecology ; Operative Time ; Pain, Postoperative - etiology ; Postoperative Period ; Prospective Studies ; Randomized clinical trial ; Republic of Korea ; Single-port ; Surgery ; Treatment Outcome ; Uterine Neoplasms - surgery</subject><ispartof>Journal of minimally invasive gynecology, 2015-07, Vol.22 (5), p.785-791</ispartof><rights>AAGL</rights><rights>2015 AAGL</rights><rights>Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-1a0d9624e0c31bc5d0f25ccd94f3c7ccd71e3e82669279ca48af54395fb911e93</citedby><cites>FETCH-LOGICAL-c411t-1a0d9624e0c31bc5d0f25ccd94f3c7ccd71e3e82669279ca48af54395fb911e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jmig.2015.02.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25757810$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Tae-Joong, MD</creatorcontrib><creatorcontrib>Shin, So-Jin, MD, PhD</creatorcontrib><creatorcontrib>Kim, Tae-Hyun, MD</creatorcontrib><creatorcontrib>Cho, Chi-Heum, MD, PhD</creatorcontrib><creatorcontrib>Kwon, Sang-Hoon, MD, PhD</creatorcontrib><creatorcontrib>Sung, SeokJu, MD, PhD</creatorcontrib><creatorcontrib>Song, Taejong, MD</creatorcontrib><creatorcontrib>Hur, Sooyoung, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yong-Man, MD, PhD</creatorcontrib><creatorcontrib>Lee, Shin-Wha, MD, PhD</creatorcontrib><creatorcontrib>Kim, Young Tae, MD, PhD</creatorcontrib><creatorcontrib>Nam, Eun Ji, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yong Beom, MD, PhD</creatorcontrib><creatorcontrib>Lee, Jung Ryeol, MD, PhD</creatorcontrib><creatorcontrib>Roh, Hyun-Jin, MD, PhD</creatorcontrib><creatorcontrib>Chung, Hyewon, MD</creatorcontrib><title>Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis</title><title>Journal of minimally invasive gynecology</title><addtitle>J Minim Invasive Gynecol</addtitle><description>Abstract Study Objective To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH). Methods Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar. Results Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay. Conclusion Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.</description><subject>Adenomyosis - surgery</subject><subject>Adult</subject><subject>Female</subject><subject>Humans</subject><subject>Hysterectomy - methods</subject><subject>Laparoendoscopic single-site surgery</subject><subject>Laparoscopic hysterectomy</subject><subject>Laparoscopy - methods</subject><subject>Leiomyoma - surgery</subject><subject>Middle Aged</subject><subject>Obstetrics and Gynecology</subject><subject>Operative Time</subject><subject>Pain, Postoperative - etiology</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Randomized clinical trial</subject><subject>Republic of Korea</subject><subject>Single-port</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Uterine Neoplasms - surgery</subject><issn>1553-4650</issn><issn>1553-4669</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UsFu1DAQjRCIlsIPcEA-cmgW24mTjYSQqhW0SFuB2Jar5XUmxSGxg8eplH7N_giX_TKcbumBA9JIHo3fe6OZN0nymtEFo6x41y7a3twsOGViQXkM_iQ5ZkJkaV4U1dPHXNCj5AViS2lWUlo8T464KEW5ZPQ4-X05dsGkxmIwYQzG2VPy1TscQAdzC6fkm7K1680d1OTKG9WR4MjK9YPyQMIP2O82o9aAGIEBkLiGbIy96SAdnA_kO3gckdw3uS-sVWQ61G4wer-7mDCAj61cP5HG-VkxtgEVerBhFruO_8YCuZxcr_Y75_e7sxpsxDs0-DJ51qgO4dXDe5Jcf_p4tbpI11_OP6_O1qnOGQspU7SuCp4D1RnbalHThgut6ypvMl3GpGSQwZLHrfGy0ipfqkbkWSWabcUYVNlJ8vagO3j3awQMsjeooeuUBTeiZDNR5MWSRig_QHUcEz00cvCmV36SjMrZNtnK2TY52yYpj8Ej6c2D_rjtoX6k_PUpAt4fABCnvDXgJWoDVkNt5vXJ2pn_63_4h647Y41W3U-YAFs3ehv3J5nESJCb-XDmu2GCUl5kNPsDNHLGNQ</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Kim, Tae-Joong, MD</creator><creator>Shin, So-Jin, MD, PhD</creator><creator>Kim, Tae-Hyun, MD</creator><creator>Cho, Chi-Heum, MD, PhD</creator><creator>Kwon, Sang-Hoon, MD, PhD</creator><creator>Sung, SeokJu, MD, PhD</creator><creator>Song, Taejong, MD</creator><creator>Hur, Sooyoung, MD, PhD</creator><creator>Kim, Yong-Man, MD, PhD</creator><creator>Lee, Shin-Wha, MD, PhD</creator><creator>Kim, Young Tae, MD, PhD</creator><creator>Nam, Eun Ji, MD, PhD</creator><creator>Kim, Yong Beom, MD, PhD</creator><creator>Lee, Jung Ryeol, MD, PhD</creator><creator>Roh, Hyun-Jin, MD, PhD</creator><creator>Chung, Hyewon, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150701</creationdate><title>Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis</title><author>Kim, Tae-Joong, MD ; Shin, So-Jin, MD, PhD ; Kim, Tae-Hyun, MD ; Cho, Chi-Heum, MD, PhD ; Kwon, Sang-Hoon, MD, PhD ; Sung, SeokJu, MD, PhD ; Song, Taejong, MD ; Hur, Sooyoung, MD, PhD ; Kim, Yong-Man, MD, PhD ; Lee, Shin-Wha, MD, PhD ; Kim, Young Tae, MD, PhD ; Nam, Eun Ji, MD, PhD ; Kim, Yong Beom, MD, PhD ; Lee, Jung Ryeol, MD, PhD ; Roh, Hyun-Jin, MD, PhD ; Chung, Hyewon, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-1a0d9624e0c31bc5d0f25ccd94f3c7ccd71e3e82669279ca48af54395fb911e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenomyosis - surgery</topic><topic>Adult</topic><topic>Female</topic><topic>Humans</topic><topic>Hysterectomy - methods</topic><topic>Laparoendoscopic single-site surgery</topic><topic>Laparoscopic hysterectomy</topic><topic>Laparoscopy - methods</topic><topic>Leiomyoma - surgery</topic><topic>Middle Aged</topic><topic>Obstetrics and Gynecology</topic><topic>Operative Time</topic><topic>Pain, Postoperative - etiology</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Randomized clinical trial</topic><topic>Republic of Korea</topic><topic>Single-port</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Uterine Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Tae-Joong, MD</creatorcontrib><creatorcontrib>Shin, So-Jin, MD, PhD</creatorcontrib><creatorcontrib>Kim, Tae-Hyun, MD</creatorcontrib><creatorcontrib>Cho, Chi-Heum, MD, PhD</creatorcontrib><creatorcontrib>Kwon, Sang-Hoon, MD, PhD</creatorcontrib><creatorcontrib>Sung, SeokJu, MD, PhD</creatorcontrib><creatorcontrib>Song, Taejong, MD</creatorcontrib><creatorcontrib>Hur, Sooyoung, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yong-Man, MD, PhD</creatorcontrib><creatorcontrib>Lee, Shin-Wha, MD, PhD</creatorcontrib><creatorcontrib>Kim, Young Tae, MD, PhD</creatorcontrib><creatorcontrib>Nam, Eun Ji, MD, PhD</creatorcontrib><creatorcontrib>Kim, Yong Beom, MD, PhD</creatorcontrib><creatorcontrib>Lee, Jung Ryeol, MD, PhD</creatorcontrib><creatorcontrib>Roh, Hyun-Jin, MD, PhD</creatorcontrib><creatorcontrib>Chung, Hyewon, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of minimally invasive gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Tae-Joong, MD</au><au>Shin, So-Jin, MD, PhD</au><au>Kim, Tae-Hyun, MD</au><au>Cho, Chi-Heum, MD, PhD</au><au>Kwon, Sang-Hoon, MD, PhD</au><au>Sung, SeokJu, MD, PhD</au><au>Song, Taejong, MD</au><au>Hur, Sooyoung, MD, PhD</au><au>Kim, Yong-Man, MD, PhD</au><au>Lee, Shin-Wha, MD, PhD</au><au>Kim, Young Tae, MD, PhD</au><au>Nam, Eun Ji, MD, PhD</au><au>Kim, Yong Beom, MD, PhD</au><au>Lee, Jung Ryeol, MD, PhD</au><au>Roh, Hyun-Jin, MD, PhD</au><au>Chung, Hyewon, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis</atitle><jtitle>Journal of minimally invasive gynecology</jtitle><addtitle>J Minim Invasive Gynecol</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>22</volume><issue>5</issue><spage>785</spage><epage>791</epage><pages>785-791</pages><issn>1553-4650</issn><eissn>1553-4669</eissn><abstract>Abstract Study Objective To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH). Methods Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar. Results Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay. Conclusion Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25757810</pmid><doi>10.1016/j.jmig.2015.02.022</doi><tpages>7</tpages></addata></record>
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subjects Adenomyosis - surgery
Adult
Female
Humans
Hysterectomy - methods
Laparoendoscopic single-site surgery
Laparoscopic hysterectomy
Laparoscopy - methods
Leiomyoma - surgery
Middle Aged
Obstetrics and Gynecology
Operative Time
Pain, Postoperative - etiology
Postoperative Period
Prospective Studies
Randomized clinical trial
Republic of Korea
Single-port
Surgery
Treatment Outcome
Uterine Neoplasms - surgery
title Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis
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