Infectious complications of laparoscopic and robotic hysterectomy: a systematic literature review and meta-analysis. Issue 3 (4th March 2019)

• Record Type: Journal Article
• Authors: Marra, Alexandre R; Puig-Asensio, Mireia; Edmond, Michael B; Schweizer, Marin L; Bender, David
• Is Part Of: International journal of gynecological cancer. Volume 29:Issue 3(2019)
• Page Start: 518
• Page End: 530
• Publication Date: 2019-03-04
• Subjects: laparoscopy -- robotic -- hysterectomy -- infectious complication -- minimally invasive technique; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2018-000098
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: We performed a systematic review of the literature and meta-analysis of the infectious complications of hysterectomy, comparing robotic-assisted hysterectomy to conventional laparoscopic-assisted hysterectomy. Methods: We searched PubMed, CINAHL, CDSR, and EMBASE through July 2018 for studies evaluating robotic-assisted hysterectomy, laparoscopic-assisted hysterectomy, and infectious complications. We employed random-effect models to obtain pooled OR estimates. Heterogeneity was evaluated with I 2 estimation and the Cochran Q statistic. Pooled ORs were calculated separately based on the reason for hysterectomy (eg, benign uterine diseases, endometrial cancer, and cervical cancer). Results: Fifty studies were included in the final review for the meta-analysis with 176 016 patients undergoing hysterectomy. There was no statistically significant difference in the number of infectious complication events between robotic-assisted hysterectomy and laparoscopic-assisted hysterectomy (pooled OR 0.97; 95 % CI 0.74 to 1.28). When we performed a stratified analysis, similar results were found with no statistically significant difference in infectious complications comparing robotic-assisted hysterectomy to laparoscopic-assisted hysterectomy among patients with benign uterine disease (pooled OR 1.10; 95 % CI 0.70 to 1.73), endometrial cancer (pooled OR 0.97; 95 % CI 0.55 to 1.73), or cervical cancer (pooled OR 1.09; 95 % CI 0.60 to 1.97). Conclusion: In our meta-analysis the rate of infectious complications associated with robotic-assisted hysterectomy was no different than that associated with conventional laparoscopic-assisted hysterectomy.