Author:
Lv Zi,Wang Yu-ying,Wang Yu-wen,He Jun-jie,Lan Wen-wei,Peng Jia-ying,Lin Zi-han,Zhu Ruo-fei,Zhou Jie,Chen Zi-qi,Jiang Ying-hui,Yuan Yi,Xiong Jian
Abstract
Abstract
Background
In previous systematic reviews, meta-analysis was lacking, resulting in the statistical difference between the data of different surgeries being impossible to judge. This meta-analysis aims to contrast the fertility results and cancer outcomes between open and minimally invasive surgery.
Method
We systematically searched databases including PubMed, Embase, Cochrane, and Scopus to collect studies that included open and minimally invasive radical trachelectomy. A random-effect model calculated the weighted average difference of each primary outcome via Review Manager V.5.4.
Result
Eight studies (1369 patients) were incorporated into our study. For fertility results, the Open group excels MIS group in pregnancies-Third trimester delivery [OR = 2.68; 95% CI (1.29, 5.59); P = 0.008]. Nevertheless, there is no statistical difference in clinical pregnancy, miscarriage, and second-trimester rate. Concerning cancer outcomes, no difference was detected in the overall survival [OR = 1.56; 95% CI (0.70, 3.45); P = 0.27] and recurrence [OR = 0.63; 95% CI (0.35, 1.12); P = 0.12]. Concerning surgery-related outcomes, the comprehensive effects revealed that the estimated blood loss of the Open group was higher than that of the MIS group[MD = 139.40; 95% CI (79.05, 199.75); P < 0.0001]. However, there was no difference between the postoperative complication rate in the two groups [OR = 1.52; 95% CI (0.89, 2.60); P = 0.12].
Conclusion
This meta-analysis suggested that the fertility result of the Open group may be better than the MIS group, while the MIS group has better surgery-related outcomes. Owing to the poor cases of our study, a more robust conclusion requires more relevant articles in the future.
Systematic review registration
PROSPERO CRD42022352999.
Funder
Research Foundation of Pediatrics College in Guangzhou Medical University
Research Foundation of Guangzhou Women and Children's Medical Center
Guangzhou Science and Technology Project
Plan on enhancing scientific research in GMU
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
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