Transvaginal versus Port-Site Specimen Retrieval after Laparoscopic Myomectomy: A Systematic Review and Meta-Analysis

Abstract

Introduction: To date, there is no robust evidence suggesting whether transvaginal retrieval (TVSR) or port-site specimen retrieval (PSSR) after laparoscopic myomectomy (LM) may lead to better surgical outcomes. Considering this element, we aimed to compare surgical outcomes of TVSR versus PSSR after LM.

Methods: A search (PROSPERO ID: CRD42020176490) of international databases, from 1980 to 2020, in English language, was conducted. We selected studies that included women who underwent LM with TVSR compared with PSSR.

Results: We did not find significant differences for operative time (MD = -8.90; 95% CI: 30.00, 12.20; I2 = 87%), myoma retrieval time (MD = -1.85; 95% CI: 13.55, 9.85; I2 = 98%), blood loss (MD = -27.62; 95% CI: 178.68, 124.43; I2 = 91%), intra-operative complication rate (OR 0.51; 95% CI: 0.01-23.09; I2 = 69%), and hospital stay (MD = -0.14; 95% CI: 0.43, 0.15; I2 = 64%); we found a significant lower postoperative rescue analgesics utilization in the TVSR group compared with the PSSR group (OR 0.31; 95% CI: 0.16-0.61; I2 = 0).

Conclusion: TVSR and PSSR after LM showed comparable results for operative time and surgery-related complications. However, the need of postoperative rescue analgesics was lower in women who underwent TVSR.

Keywords: Complications; Laparoscopic myomectomy; Port-site extraction; Posterior colpotomy; Surgical specimen retrieval; Transvaginal extraction.