Perioperative Outcomes of Laparoendoscopic Single-site Extracorporeal Versus Intracorporeal Cystectomy for Benign Ovarian Cysts: a Retrospective Cohort Study Based on Propensity Score Matching

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2022 Jan 24

PMID 35071419

Authors

Wenwei Tan

Shuai Tang

Yuanyang Yao

Yuan Deng

Kuiyan Zhong

Zhiqing Liang

Li Deng

Yanzhou Wang

Affiliations

Soon will be listed here.

Abstract

Background: Ovarian cysts are the most common gynecological disease, and laparo-endoscopic single-site (LESS) cystectomy is a popular surgical procedure. A new laparoscopic technique combining the advantages of LESS surgery and open surgery has been introduced to treat large ovarian cysts. To our knowledge, no previous research has compared LESS-extracorporeal (LESS-E) cystectomy to LESS-intracorporeal (LESS-I) cystectomy. This study compared the perioperative results of LESS-E cystectomy and LESS-I cystectomy in the treatment of benign ovarian cysts.

Methods: Two hundred eighty-eight cases of cystectomy from our institutional database were retrospectively reviewed. 1:1 propensity score matching (PSM) was performed to minimize bias due to any imbalanced baseline features between the 2 groups, which were matched in terms of age, body mass index, and the largest diameter of ovarian cysts. Seventy-nine cases were then selected from each group, and the perioperative outcomes of the 2 cohorts were analyzed.

Results: The mean (standard deviation) largest diameter of ovarian cysts was 8.30 (3.56) cm in the LESS-I group and 9.14 (3.15) cm in the LESS-E group (P=0.118). No statistically significant difference was found between the 2 groups in terms of estimated blood loss, postoperative hemoglobin decline, postoperative pain in 24 hours, postoperative hospital stay, and total hospital costs (P>0.05). However, the mean operation time of the LESS-E group was shorter than that of the LESS-I group (85.01 104.25 minutes; P=0.001). Additionally, the spillage rate of the LESS-I group was significantly greater than that of the LESS-E group (46.8% 17.7%; P<0.001). The mean pain scores at 6 postoperative hours as measured by a visual analogue scale were significantly greater in the LESS-I group than the LESS-E group (3.85 3.37; P=0.016).

Conclusions: LESS-E cystectomy is a safe and feasible approach with a shorter operation time and lower spillage rate than LESS-I cystectomy.

Citing Articles

Comparison between Robotic Single-Site and Laparoendoscopic Single-Site Hysterectomy: Multicentric Analysis of Surgical Outcomes.

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PMID: 36676747 PMC: 9866110. DOI: 10.3390/medicina59010122.

A preoperative scoring system to predict the probability of laparoendoscopic single-site extracorporeal cystectomy in patients with benign ovarian cysts.

Tan W, Deng Y, Deng L, Tang S, Yao Y, Wei H Front Surg. 2022; 9:991450.

PMID: 36386511 PMC: 9643379. DOI: 10.3389/fsurg.2022.991450.

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