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Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

  • Wang, Hui-Ling (Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xinxiang Medical University) ;
  • Ren, Yan-Fang (Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xinxiang Medical University) ;
  • Yang, Jun (Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xinxiang Medical University) ;
  • Qin, Rui-Ying (Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xinxiang Medical University) ;
  • Zhai, Kai-Hua (Department of Neurology, the First Affiliated Hospital of Xinxiang Medical University)
  • Published : 2013.04.30

Abstract

The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH), while total laparoscopic hysterectomy (TLH) is less invasive and assumed to be associated with lower morbidity. This meta-analysis was performed to investigate the effects of TLH versus TAH in women with early-stage endometrial cancer. We searched the PubMed, EMBASE, CBM and Cochrane Review databases for randomized trials assessing the effects of TLH versus TAH in women with early-stage endometrial cancer. The relative risks (RR) with 95% confidence intervals (CIs) from each study were pooled using meta-analysis. In our study, 9 randomized trials with a total of 1,263 patients were included. Meta-analyses showed that TLH was associated with lower risks of major complications (RR = 0.53, 95%CI 0.29-0.98, P = 0.042), total complications (RR = 0.59, 95%CI 0.42-0.82, P = 0.002) and postoperative complications (RR = 0.57, 95%CI 0.40-0.83, P = 0.003). However, there were no obvious differences in risks of intra-operative complications (RR = 0.98, 95%CI 0.62-1.55, P = 0.919) and mortality (RR = 0.96, 95%CI 0.66-1.40, P = 0.835). In conclusion, our results provide new evidence of a benefit for TLH over TAH in terms of major complications, total complications and postoperative complications in endometrial cancer patients.

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