Quality of life following minimally invasive hysterectomy compared to abdominal hysterectomy: A metanalysis

Helena C Bartels; Ailin C Rogers; Monika Janda; Andreas Obermair; Donal J Brennan

doi:10.1016/j.ejogrb.2020.06.055

Quality of life following minimally invasive hysterectomy compared to abdominal hysterectomy: A metanalysis

Eur J Obstet Gynecol Reprod Biol. 2020 Sep:252:206-212. doi: 10.1016/j.ejogrb.2020.06.055. Epub 2020 Jun 28.

Authors

Helena C Bartels¹, Ailin C Rogers², Monika Janda³, Andreas Obermair³, Donal J Brennan⁴

Affiliations

¹ Ireland East Hospital Gynae Oncology Group, Mater Misericordiae University, Dublin 7, Ireland.
² Dept of Surgery, Mater Misericordiae University Hospital, Dublin 7, Ireland.
³ Queensland Centre for Gynaecological Cancer Research, University of Queensland, Centre for Clinical Research, RBWH, Herston, QLD, Australia.
⁴ Ireland East Hospital Gynae Oncology Group, Mater Misericordiae University, Dublin 7, Ireland; UCD School of Medicine, Mater Misericordiae University Hospital, Dublin 2, Ireland. Electronic address: donal.brennan@ucd.ie.

PMID: 32623252
DOI: 10.1016/j.ejogrb.2020.06.055

Abstract

Objective: The aim of this meta-analysis is to review quality of life (QoL) in patients who underwent simple minimally invasive (MIS) hysterectomy compared to abdominal hysterectomy (AH) for benign conditions or endometrial cancer.

Methods: A literature search was performed of electronic databases including Cochrane, Medline, Pubmed, Pubmed Central, clinicaltrials.gov and Embase from study inception until December 2019. Search terms included "QoL", "minimally invasive surgery" "laparoscopic hysterectomy" "abdominal hysterectomy". The literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results were reported as mean differences or pooled odds ratios (OR) with 95 % confidence intervals (95 % CI).

Results: A total of 4988 citations were reviewed; 9 studies comprising 3116 patients were selected for the analysis. Publications reporting QoL in patients undergoing simple MIS hysterectomy compared to AH were included. 9 studies reporting 3 different QoL assessment tools were included: EuroQoL five dimensions visual analogue scale (EQ-5D-VAS), Functional Assessment of Cancer Therapy-General (FACT-G) and Short Form-36 (SF-36). For EQ-5D, patients in the MIS group had a significantly higher QoL compared to those in the AH group at 1 week (OR 9.82, 95 % CI 4.61-15.03, p = 0.0002) and 4 weeks (OR 4.83 95 % CI 0.71-8.95, p = 0.02) post-operatively. Similarly, for FACT-G, at 1 week and at 4 weeks post operatively, patients in the MIS group reported a significantly higher score compared to those in the AH group (1 week: OR 6.39, 95 % CI 3.16-9.61, p = 0.0001, 4 weeks: OR 6.33, 95 % CI 3.55-9.12, p = <0.00001). There was no difference in SF-36 scores at any time point between the groups.

Conclusion: MIS hysterectomy is associated with improved QoL in the short term post-operative phase compared to AH both for benign disease and endometrial cancer.

Keywords: Abdominal hysterectomy; Endometrial cancer; Hysterectomy; Minimally invasive; Quality of life.

Publication types

Meta-Analysis
Review

MeSH terms

Endometrial Neoplasms* / surgery
Female
Humans
Hysterectomy
Laparoscopy*
Minimally Invasive Surgical Procedures
Quality of Life