Original Investigation

Systematic review, meta-analysis and statistical analysis of laparoscopic supracervical hysterectomy vs endometrial ablation

10.4274/jtgga.galenos.2021.2020.0185

  • Greg J. Marchand
  • Ali Azadi
  • Katelyn Sainz
  • Ahmed Masoud
  • Sienna Anderson
  • Stacy Ruther
  • Kelly Ware
  • Sophia Hopewell
  • Giovanna Brazil
  • Alexa King
  • Jannelle Vallejo
  • Kaitlynne Cieminski
  • Anthony Galitsky
  • Allison Steele
  • Jennifer Love

Received Date: 13.10.2020 Accepted Date: 14.01.2021 J Turk Ger Gynecol Assoc 0;0(0):0-0 [e-Pub]

Objective:

This meta-analysis aims to compare the effect of laparoscopic supracervical hysterectomy with endometrial ablation (EA) regarding the general and menstrual-related quality of life in women opting for surgical treatment for abnormal uterine bleeding.

Material and Methods:

We searched PubMed, Cochrane Library, SCOPUS, and Web of Science for relevant clinical trials. Our main outcomes of interest included quality of life assessed using medical outcomes survey short form 36 (SF-36), survey short form 12 (SF-12), operation time, time from operation to discharge, pain, fever, and hemoglobin level. Screening and data extraction were performed independently and the analysis was conducted using Review Manager Software v5.4.1.

Results:

We included four clinical trials, results of SF-12 score showed that for both MCS and PCS, the overall mean difference revealed no significant difference between both groups (MD= -4.15 [-16.01, 7.71], (P=0.49), and (MD= 2.67 [-0.37, 5.71], (P = 0.08) respectively. Subgroup analysis of the SF-36 score showed that only two components (general health and social function) were significantly improved in the hysteroscopy group (P<0.01), the other six components were not significant (P>0.05). The overall mean difference favored EA group significantly in terms of operation time (MD=72.65 [35.48, 109.82], (P = 0.0001), time from operation to discharge (MD=13.61 [3.21, 24.01], (P = 0.01), hemoglobin level outcome (MD=0.57 [0.40, 0.74], (P < 0.01), and pain score (SMD= 0.46 [0.32, 0.60], (P < 0.01).

Conclusion:

Laparoscopic supracervical hysterectomy has better outcomes in regards to quality of life. This includes patient indicated responses to social health, general health, and superior hemoglobin levels at all measured points postoperatively. EA, however, consistently is associated with less operative time, a shorter hospital stay and is also considered as a more minimally invasive technique which also can also result in satisfying outcomes.