Evaluation of evidence using GRADE criteria.

ObjectiveThis study aimed to compare the surgical outcomes in patients with endometrial cancer who underwent either single-port laparoscopic hysterectomy (SPLH) or multi-port laparoscopic hysterectomy (MPLH).MethodsWe conducted a systematic literature search from the earliest records available up to May 2023. The databases searched included PubMed, Embase, ClinicalTrials.gov, and the Cochrane Library.ResultsA total of 12 studies were included in the analysis. Both the SPLH and MPLH groups had similar operative times (MD = -4.27, 95% CI [-35.75, 27.22], p = 0.98), conversion rates (odds ratio [OR] = 1.43, 95% CI [0.57, 3.59], p = 0.44), blood transfusion rates, intraoperative complications (bladder injury, bowel injury, and vascular injury), and postoperative complications (umbilical hernia, fever, fistula, lymphocyst, and wound-related issues). However, the SPLH group showed significant advantages in certain areas. There was a notable reduction in estimated intraoperative blood loss (EBL) compared to the MPLH group (mean difference [MD] = -23.80, 95% CI [-42.99, -4.62], p = 0.02) and a shorter hospital stay duration (MD = -0.33, 95% CI [-0.46, -0.20], p ConclusionSPLH and MPLH techniques are equally effective in treating endometrial cancer, with both showing low rates of surgical complications with similar rates of surgical complications and therapeutic outcomes. However, SPLH offers additional benefits, including smaller incisions, reduced estimated intraoperative blood loss, and shorter hospital stays, making it an increasingly popular option for treating endometrial cancer.

研究目的 本研究旨在对比接受单孔腹腔镜子宫切除术（single-port laparoscopic hysterectomy，SPLH）与多孔腹腔镜子宫切除术（multi-port laparoscopic hysterectomy，MPLH）的子宫内膜癌患者的手术结局。
研究方法 本研究于2023年5月前，从最早的可用记录起开展系统文献检索，检索数据库包括PubMed、Embase、ClinicalTrials.gov及考克兰图书馆（Cochrane Library）。
研究结果 本研究共纳入12项分析研究。SPLH组与MPLH组的手术时间（均数差[mean difference，MD] = -4.27，95%置信区间[CI] [-35.75, 27.22]，p = 0.98）、中转手术率（比值比[odds ratio，OR] = 1.43，95%置信区间[CI] [0.57, 3.59]，p = 0.44）、输血率、术中并发症（膀胱损伤、肠损伤及血管损伤）及术后并发症（脐疝、发热、瘘管、淋巴囊肿及伤口相关并发症）均无显著差异。但SPLH组在部分领域表现出显著优势：相较于MPLH组，SPLH组的术中估计失血量（estimated intraoperative blood loss，EBL）显著降低（均数差[mean difference，MD] = -23.80，95%置信区间[CI] [-42.99, -4.62]，p = 0.02），且住院时长更短（均数差[mean difference，MD] = -0.33，95%置信区间[CI] [-0.46, -0.20]，p）。
研究结论 SPLH与MPLH技术治疗子宫内膜癌的疗效相当，二者均具有较低的手术并发症发生率，手术结局与并发症发生率相似。但SPLH具备额外优势，包括更小的手术切口、更低的术中估计失血量及更短的住院时长，使其成为治疗子宫内膜癌的日益流行的选择。