title: Laparoendoscopic single-site versus conventional laparoscopic gynecologic surgery: a metaanalysis of randomized controlled trials.
abstract: OBJECTIVE
  To assess the current evidence regarding the efficiency, safety, and potential advantages of laparoendoscopic single-site surgery (LESS) for treating gynecologic diseases.
  
  
  METHODS
  We comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to December 2012. Two authors screened out duplicates and independently reviewed eligibility of each study. We included randomized controlled trials comparing LESS with conventional laparoscopy (CL) for treating gynecologic diseases. The primary outcomes were perioperative complication rate, conversion rate, postoperative pain, and cosmetic satisfaction.
  
  
  RESULTS
  We included 6 randomized controlled trials with 439 participants in the final analysis. There were no significant differences between LESS and CL in terms of perioperative complication rate (15.5% and 14.3%; risk ratio, 1.11; 95% confidence interval [CI], 0.74-1.67; P = .61), conversion rate (3.8% and 1.1%; risk ratio, 2.75; 95% CI, 0.73-10.33; P = .13), postoperative pain (weighted mean difference [WMD], -0.22; 95% CI, -1.29 to 0.85; P = .68), analgesic requirement (WMD, 0.41; 95% CI, -1.69 to 2.51; P = .70), and cosmetic satisfaction (WMD, 0.19; 95% CI, -0.30 to 0.68; P = .46). There were also no differences in terms of operative time (P = .65), hemoglobin change (P = .23), time to first flatus (P = .17), and length of hospital stay (P = .99) between both techniques.
  
  
  CONCLUSIONS
  This metaanalysis provides evidence that LESS is comparable in the efficacy and safety, but does not offer potential advantage such as better cosmesis and lesser pain compared with CL for treating gynecologic diseases.
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.forename: Mi-La
authors.initials: ML
authors.lastname: Kim
authors.forename: Yong Wook
authors.initials: YW
authors.lastname: Jung
authors.forename: Bo Sung
authors.initials: BS
authors.lastname: Yoon
authors.forename: Won Duk
authors.initials: WD
authors.lastname: Joo
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery*; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D014599:Uterus / Q000601:surgery*
keywords: LESS; gynecologic; laparoendoscopic single-site; laparoscopy; metaanalysis