Transvaginal versus Port-Site Specimen Retrieval after Laparoscopic Myomectomy: A Systematic Review and Meta-Analysis
Antonio Simone Laganà, Amerigo Vitagliano, Jvan Casarin, Simone Garzon, Stefano Uccella, Massimo Piergiuseppe Franchi, Antonella Cromi, Fabio Ghezzi
Abstract
<b><i>Introduction:</i></b> To date, there is no robust evidence suggesting whether transvaginal retrieval (TVSR) or port-site specimen retrieval (PSSR) after laparoscopic myomectomy (LM) may lead to better surgical outcomes. Considering this element, we aimed to compare surgical outcomes of TVSR versus PSSR after LM. <b><i>Methods:</i></b> A search (PROSPERO ID: CRD42020176490) of international databases, from 1980 to 2020, in English language, was conducted. We selected studies that included women who underwent LM with TVSR compared with PSSR. <b><i>Results:</i></b> We did not find significant differences for operative time (MD = −8.90; 95% CI: 30.00, 12.20; <i>I</i><sup>2</sup> = 87%), myoma retrieval time (MD = −1.85; 95% CI: 13.55, 9.85; <i>I</i><sup>2</sup> = 98%), blood loss (MD = −27.62; 95% CI: 178.68, 124.43; <i>I</i><sup>2</sup> = 91%), intra-operative complication rate (OR 0.51; 95% CI: 0.01–23.09; <i>I</i><sup>2</sup> = 69%), and hospital stay (MD = −0.14; 95% CI: 0.43, 0.15; <i>I</i><sup>2</sup> = 64%); we found a significant lower postoperative rescue analgesics utilization in the TVSR group compared with the PSSR group (OR 0.31; 95% CI: 0.16–0.61; <i>I</i><sup>2</sup> = 0). <b><i>Conclusion:</i></b> TVSR and PSSR after LM showed comparable results for operative time and surgery-related complications. However, the need of postoperative rescue analgesics was lower in women who underwent TVSR.