Meta-analysis of randomized trials finds poorer survival after minimally invasive hysterectomy in cervical cancer, indicating open abdominal surgery provides safer oncological outcomes.
Background: Consensus is lacking regarding the relative safety and oncological outcomes of minimally invasive compared to abdominal hysterectomy. Objectives: To estimate complications and survival rates of minimally invasive hysterectomy (i.e., laparoscopic or robotic assisted) compared to total abdominal hysterectomy for endometrial and cervical cancer. Methods: A systematic quantitative review of randomised controlled trials (RCTs) comparing minimally invasive hysterectomy with total abdominal hysterectomy (TAH) for the treatment of endometrial or cervical cancer. Medline-PubMed, Cochrane Library, Scopus, ongoing clinical trials and the grey literature were searched until December 1, 2024. Main Outcome Measures: Complications, overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates. Results: : 0%) respectively. Conclusions: Bladder and vaginal injuries are higher with minimally invasive compared to abdominal hysterectomy. Survival rates for endometrial cancer are comparable but for cervical cancer, minimally invasive hysterectomy is associated with poorer survival outcomes and this should be taken into account when counselling patients and deciding upon the route of hysterectomy. What is New?: TAH has superior survival outcomes compared to minimally invasive hysterectomy.
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Theodoridis et al. (2026) studied this question.
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