title: Single-port Access Subtotal Laparoscopic Hysterectomy: A Prospective Case-Control Study.
abstract: OBJECTIVE
  The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH).
  
  
  METHODS
  Case-control study. Canadian Task Force Classification II-2.
  
  
  METHODS
  The study was conducted at university hospitals in Cagliari, Italy, and Rouen, France.
  
  
  METHODS
  Sixty-one women with metrorrhagia, abnormal uterine bleeding with uterine myomas, or symptomatic adenomyosis were included in the study.
  
  
  METHODS
  Thirty-one patients underwent SPAL-SH, and 30 patients underwent conventional MPAL-SH.
  
  
  RESULTS
  We analyzed the data to compare the outcomes of SPAL-SH versus MPAL-SH. Patients in the SPAL-SH group had longer operative times than those in the MPAL-SH group (p < .001) but shorter hospital stays (p < .001). Postoperative pain immediately after surgery, after 6 hours, and after 24 hours were lower in the SPAL-SH group (p < .001). The SPAL-SH group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01).
  
  
  CONCLUSIONS
  We conclude that SPAL-SH is a feasible and safe alternative to standard MPAL-SH in selected patients. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. In addition, SPAL-SH has a definite benefit in relation to body image and cosmesis.
authors: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: sangioni@yahoo.it.
authors: Stefano
authors: S
authors: Angioni
authors: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
authors: Alessandro
authors: A
authors: Pontis
authors: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
authors: Adolfo
authors: A
authors: Pisanu
authors: Department of Obstetrics and Gynaecology, Hospital Santa Maria Chiara, Trento, Italy.
authors: Liliana
authors: L
authors: Mereu
authors: Department of Obstetrics and Gynaecology, University of Rouen, Rouen, France.
authors: Horace
authors: H
authors: Roman
mesh_terms: D062788:Adenomyosis / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay; D008796:Metrorrhagia / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Laparoscopic subtotal hysterectomy; SPAL; Single-port access laparoscopy