Cochrane · systematic review · CD003677
Surgical approach to hysterectomy for benign gynaecological disease
Pickett, CM, Seeratan, DD, Mol, BWJ, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
35
current version
GRADE rated
19
No studies
16
Included studies
NR
No studies 16 · 45.7%Ungraded 0 · 0%Very low 5 · 14.3%Low 13 · 37.1%Moderate 1 · 2.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 2 versionsVaginal hysterectomy versus abdominal hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) Vaginal hysterectomy vs abdominal hysterectomy | no estimate extracted | 4 studies · 274 participants | Moderate Downgraded: inconsistency |
Long‐term outcomes Vaginal hysterectomy vs abdominal hysterectomy | OR 2.69 [0.5, 14.42] | 1 study · 119 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Long‐term complications (dichotomous) Vaginal hysterectomy vs abdominal hysterectomy | OR 3.2 [0.32, 31.9] | 2 studies · 177 participants | Low Downgraded: risk of bias, imprecision |
Intra‐operative visceral injury (dichotomous) Vaginal hysterectomy vs abdominal hysterectomy | OR 1.62 [0.52, 4.99] | 7 studies · 697 participants | Low Downgraded: risk of bias, imprecision |
Major short‐term complications (dichotomous) Vaginal hysterectomy vs abdominal hysterectomy | OR 3.14 [0.48, 20.55] | 3 studies · 216 participants | Low Downgraded: risk of bias, imprecision |
Laparoscopic hysterectomy versus abdominal hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) Laparoscopic hysterectomy vs abdominal hysterectomy | no estimate extracted | 7 studies · 618 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Long‐term outcomes Laparoscopic hysterectomy vs abdominal hysterectomy | OR 0.65 [0.32, 1.3] | 1 study · 166 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Long‐term complications (dichotomous) Laparoscopic hysterectomy vs abdominal hysterectomy | OR 0.94 [0.49, 1.82] | 3 studies · 343 participants | Low Downgraded: risk of bias, imprecision |
Intra‐operative visceral injury(dichotomous) Laparoscopic hysterectomy vs abdominal hysterectomy | OR 1.68 [0.88, 3.22] | 15 studies · 2298 participants | Low Downgraded: risk of bias, imprecision |
Major short‐term complications (dichotomous) Laparoscopic hysterectomy vs abdominal hysterectomy | OR 1.43 [0.67, 3.04] | 9 studies · 852 participants | Low Downgraded: risk of bias, imprecision |
Laparoscopic hysterectomy versus vaginal hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) Laparoscopic hysterectomy vs vaginal hysterectomy | no estimate extracted | 3 studies · 238 participants | Low Downgraded: imprecision |
Long‐term outcomes Laparoscopic hysterectomy vs vaginal hysterectomy | no estimate extracted | NR | No studies |
Long‐term complications (dichotomous) Laparoscopic hysterectomy vs vaginal hysterectomy | OR 1 [0.25, 4.07] | 3 studies · 248 participants | Low Downgraded: risk of bias, imprecision |
Intra‐operative visceral injury (dichotomous) Laparoscopic hysterectomy vs vaginal hysterectomy | OR 0.93 [0.37, 2.33] | 10 studies · 1237 participants | Low Downgraded: risk of bias, imprecision |
Major short‐term complications (dichotomous) Laparoscopic hysterectomy vs vaginal hysterectomy | OR 0.98 [0.22, 4.39] | 4 studies · 276 participants | Low Downgraded: risk of bias, imprecision |
Robotic hysterectomy compared to laparoscopic hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) Robotic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Long‐term outcomes Robotic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Long‐term complications (dichotomous) Robotic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Intra‐operative visceral injury (dichotomous) Robotic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Major short‐term complications (dichotomous) Robotic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Single‐port laparoscopic hysterectomy compared to laparoscopic hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) Single‐port laparoscopic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Long‐term outcomes Single‐port laparoscopic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Long‐term complications (dichotomous) Single‐port laparoscopic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Intra‐operative visceral injury (dichotomous) Single‐port laparoscopic hysterectomy vs laparoscopic hysterectomy | OR 3.51 [0.14, 89.42] | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Major short‐term complications (dichotomous) Single‐port laparoscopic hysterectomy vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Total laparoscopic hysterectomy compared to laparoscopic‐assisted vaginal hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) Total laparoscopic hysterectomy vs laparoscopic‐assisted vaginal hysterectomy | no estimate extracted | NR | No studies |
Long‐term outcomes Total laparoscopic hysterectomy vs laparoscopic‐assisted vaginal hysterectomy | no estimate extracted | NR | No studies |
Long‐term complications (dichotomous) Total laparoscopic hysterectomy vs laparoscopic‐assisted vaginal hysterectomy | no estimate extracted | NR | No studies |
Intra‐operative visceral injury (dichotomous) Total laparoscopic hysterectomy vs laparoscopic‐assisted vaginal hysterectomy | OR 0.72 [0.06, 8.27] | 2 studies · 161 participants | Low Downgraded: risk of bias, imprecision |
Major short‐term complications (dichotomous) Total laparoscopic hysterectomy vs laparoscopic‐assisted vaginal hysterectomy | OR 0.28 [0.03, 2.45] | 1 study · 101 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
V‐NOTES compared to laparoscopic hysterectomy for benign gynaecological disease
Population: patients with benign gynaecological disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Return to normal activities (days) V‐NOTES vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Long‐term outcomes V‐NOTES vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Long‐term complications (dichotomous) V‐NOTES vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |
Intra‐operative visceral injury (dichotomous) V‐NOTES vs laparoscopic hysterectomy | OR 3.09 [0.12, 78.41] | 2 studies · 96 participants | Low Downgraded: imprecision |
Major short‐term complications (dichotomous) V‐NOTES vs laparoscopic hysterectomy | no estimate extracted | NR | No studies |