Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH), while totallaparoscopic hysterectomy (TLH) is less invasive and assumed to be associated with lower morbidity. This metaanalysiswas performed to investigate the effects of TLH versus TAH in women with early-stage endometrialcancer. We searched the PubMed, EMBASE, CBM and Cochrane Review databases for randomized trialsassessing the effects of TLH versus TAH in women with early-stage endometrial cancer. The relative risks (RR)with 95% confidence intervals (CIs) from each study were pooled using meta-analysis. In our study, 9 randomizedtrials with a total of 1,263 patients were included. Meta-analyses showed that TLH was associated with lowerrisks of major complications (RR = 0.53, 95%CI 0.29-0.98, P = 0.042), total complications (RR = 0.59, 95%CI0.42-0.82, P = 0.002) and postoperative complications (RR = 0.57, 95%CI 0.40-0.83, P = 0.003). However, therewere no obvious differences in risks of intra-operative complications (RR = 0.98, 95%CI 0.62-1.55, P = 0.919)and mortality (RR = 0.96, 95%CI 0.66-1.40, P = 0.835). In conclusion, our results provide new evidence of abenefit for TLH over TAH in terms of major complications, total complications and postoperative complicationsin endometrial cancer patients.