title: Multi-institution, Prospective, Randomized Trial to Compare the Success Rates of Single-port Versus Multiport Laparoscopic Hysterectomy for the Treatment of Uterine Myoma or Adenomyosis.
abstract: OBJECTIVE
  To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH).
  
  
  METHODS
  Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. Primary outcome was conversion and/or complication proportion of the planned procedure to determine whether the success proportion of the single-port approach was not inferior to that of the multiport approach. Secondary outcomes were postoperative pain and operative scar.
  
  
  RESULTS
  Demographic parameters including age, body mass index, parity, and history of vaginal and cesarean delivery were comparable between the 2 groups. The primary outcome of a combined conversion and/or complication rate was similar between the single-port and multiport groups at 8% and 10.3%, respectively. Conversions were similar between the groups with 4% of single-port cases and .8% of multiport cases. Transfusions were the most frequent complication required in 4.0% of single-port cases and 7.9% of multiport cases, with no difference between the groups. Concerning secondary outcomes, postoperative pain score and patient and observer scar assessment were not different between the 2 groups. Although not a specific outcome measure, there was no difference between the groups in blood loss, operative time, and postoperative hospital stay.
  
  
  CONCLUSIONS
  Single-port LH is not inferior to multiport LH in terms of conversion and/or complications rates, including transfusion. However, the single-port approach did not have any advantage over multiport LH with regard to pain or cosmetic outcomes. These findings were demonstrated by multi-institutional surgeons in Korea.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Tae-Joong
authors.initials: TJ
authors.lastname: Kim
authors.affiliation: Keimyung University School of Medicine, Daegu, Korea.
authors.forename: So-Jin
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Keimyung University School of Medicine, Daegu, Korea. Electronic address: chcho@kmu.ac.kr.
authors.forename: Chi-Heum
authors.initials: CH
authors.lastname: Cho
authors.affiliation: Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Kwon
authors.affiliation: CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: SeokJu
authors.initials: S
authors.lastname: Sung
authors.affiliation: CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.affiliation: The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Sooyoung
authors.initials: S
authors.lastname: Hur
authors.affiliation: University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Yong-Man
authors.initials: YM
authors.lastname: Kim
authors.affiliation: University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Shin-Wha
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Yonsei University College of Medicine, Severance Medical Center, Seoul, Korea.
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.affiliation: Yonsei University College of Medicine, Severance Medical Center, Seoul, Korea.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Nam
authors.affiliation: Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jung Ryeol
authors.initials: JR
authors.lastname: Lee
authors.affiliation: College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Korea.
authors.forename: Hyun-Jin
authors.initials: HJ
authors.lastname: Roh
authors.affiliation: Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hyewon
authors.initials: H
authors.lastname: Chung
mesh_terms: D062788:Adenomyosis / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D011184:Postoperative Period; D011446:Prospective Studies; D056910:Republic of Korea; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Laparoendoscopic single-site surgery; Laparoscopic hysterectomy; Randomized clinical trial; Single-port