PMID- 23332717
OWN - NLM
STAT- MEDLINE
DCOM- 20131001
LR  - 20220409
IS  - 1553-4669 (Electronic)
IS  - 1553-4650 (Linking)
VI  - 20
IP  - 2
DP  - 2013 Mar-Apr
TI  - Minilaparoscopic versus single-port total hysterectomy: a randomized trial.
PG  - 192-7
LID - S1553-4650(12)01320-9 [pii]
LID - 10.1016/j.jmig.2012.11.007 [doi]
AB  - STUDY OBJECTIVE: To compare perioperative outcomes and postoperative pain of 
      minilaparoscopic (M-LPS) and laparoendoscopic single-site total hysterectomy 
      (LESS). DESIGN: Prospectively randomized study (Canadian Task Force 
      classification II-2). SETTING: Department of Obstetrics and Gynecology, Division 
      of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome. PATIENTS: 
      A total of 86 patients underwent total hysterectomy. Seventy-one met the 
      inclusion criteria and were included in this study. Three of them refused 
      randomization, 34 were randomly assigned to undergo to single-port hysterectomy 
      and 34 to undergo to minilaparoscopy. INTERVENTIONS: The operative technique is 
      the same in the 2 groups with the exception of videolaparoscopy, port type, and 
      some specific instruments. All surgical procedures were performed with an 
      intrauterine manipulator. Single-port hysterectomy was performed through a 
      multichannel single trocar inserted in the umbilicus. Minilaparoscopic 
      hysterectomy was performed through one optical transumbilical 5-mm trocar and 
      three 3-mm suprapubic ancillary ports. MEASUREMENTS AND MAIN RESULTS: Sixty-eight 
      patients met the inclusion criteria and were enrolled in the study. The 
      baseline characteristics of the 2 groups were comparable. Median operative time 
      was longer in LESS with respect to M-LPS (120 minutes vs 90 minutes; p = .038). 
      There were no differences between the 2 groups for median estimated blood loss, 
      ileus, and postoperative stay. Additional 5-mm port insertion was needed in 1 
      case (2.9%) in the M-LPS group and in 2 cases (5.9%) in the LESS group, 
      respectively (p = .311). No patient had development of intraoperative or early 
      postoperative complications. Patients in the M-LPS group experienced a minor pain 
      at each evaluation, compared with patients who underwent LESS. The rescue 
      analgesic requirement was similar in the 2 groups. CONCLUSIONS: Laparoscopic 
      hysterectomy can be safely performed by M-LPS and LESS. M-LPS is associated with 
      significantly lower operative time and less postoperative pain than LESS. 
      Advantages of M-LPS hysterectomy than LESS have no noteworthy impact on the 
      patients' early postoperative management. The decision on the best access to the 
      hysterectomy might take into account the surgeon's skill and feeling with the 
      different possible approaches.
CI  - Copyright (c) 2013 AAGL. Published by Elsevier Inc. All rights reserved.
FAU - Fanfani, Francesco
AU  - Fanfani F
AD  - Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 
      Catholic University of the Sacred Heart, Rome, Italy. 
      francesco.fanfani@rm.unicatt.it
FAU - Fagotti, Anna
AU  - Fagotti A
FAU - Gagliardi, Maria Lucia
AU  - Gagliardi ML
FAU - Monterossi, Giorgia
AU  - Monterossi G
FAU - Rossitto, Cristiano
AU  - Rossitto C
FAU - Costantini, Barbara
AU  - Costantini B
FAU - Gueli Alletti, Salvatore
AU  - Gueli Alletti S
FAU - Vizzielli, Giuseppe
AU  - Vizzielli G
FAU - Ercoli, Alfredo
AU  - Ercoli A
FAU - Scambia, Giovanni
AU  - Scambia G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130117
PL  - United States
TA  - J Minim Invasive Gynecol
JT  - Journal of minimally invasive gynecology
JID - 101235322
RN  - 0 (Analgesics)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analgesics/therapeutic use
MH  - Blood Loss, Surgical
MH  - Chi-Square Distribution
MH  - Female
MH  - Humans
MH  - Hysterectomy/adverse effects/*methods
MH  - Ileus/etiology
MH  - Laparoscopy/adverse effects/*methods
MH  - Length of Stay
MH  - Middle Aged
MH  - Operative Time
MH  - Pain, Postoperative/*etiology
MH  - Statistics, Nonparametric
EDAT- 2013/01/22 06:00
MHDA- 2013/10/18 06:00
CRDT- 2013/01/22 06:00
PHST- 2012/09/27 00:00 [received]
PHST- 2012/11/19 00:00 [revised]
PHST- 2012/11/21 00:00 [accepted]
PHST- 2013/01/22 06:00 [entrez]
PHST- 2013/01/22 06:00 [pubmed]
PHST- 2013/10/18 06:00 [medline]
AID - S1553-4650(12)01320-9 [pii]
AID - 10.1016/j.jmig.2012.11.007 [doi]
PST - ppublish
SO  - J Minim Invasive Gynecol. 2013 Mar-Apr;20(2):192-7. doi: 
      10.1016/j.jmig.2012.11.007. Epub 2013 Jan 17.