The efficacy of single-incision laparoscopic surgery versus conventional laparoscopic surgery in the surgical management of ectopic pregnancy: A systematic review and meta-analysis.

Abstract

To compare the efficacy and safety of single-incision laparoscopic surgery (SILS) versus conventional laparoscopic surgery (CLS) for the surgical management of ectopic pregnancy through a systematic review and meta-analysis. We searched Medline, PubMed, Scopus, Web of Science, ClinicalTrials.gov, and Cochrane databases from inception to May, 2023 for studies comparing SILS with CLS in ectopic pregnancy treatment. Included studies were controlled and observational, excluding single-arm studies, meta-analyses, and reviews. Quality was assessed using ROBINS-I for observational studies and the Cochrane tool for randomized trials. Data were analyzed with OpenMetaAnalyst and Review Manager 5.4.1, using odds ratios for dichotomous outcomes and mean differences (MD) for continuous outcomes. Twelve studies involving 880 women (372 SILS, 508 CLS) were included. SILS showed significantly less blood loss (MD=-51.01 mL, p=0.004), shorter postoperative hospital stay (MD=-0.24 days, p=0.003), and faster return of bowel function (MD=-1.03 hours, p<0.01), compared to CLS. No significant differences were found in total operative time, hemoglobin change, blood transfusion requirements, or number of patients needing transfusions. Patient satisfaction data were limited but suggested better cosmetic outcomes with SILS. SILS is a feasible and effective alternative to CLS for ectopic pregnancy, offering reduced blood loss, shorter hospital stays, and quicker bowel function recovery. These benefits, alongside potential cosmetic advantages, make SILS a promising option, particularly for young women. Further research is needed to confirm long-term outcomes and optimize patient selection.