Liu Ying, Zhang Qiang, Huang Biao, Li Xin, Liu Tianjiao, Xu Lijuan, Liao Xiaoyan, Liao Jianmei, Cheng Wei, Wang Hui, Huang Juan, Wu Tenglan, Liu Yan, Yu Jie, Lin Yonghong, Gan Xiaoqin
Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Bazhong Maternal and Child Health Hospital, Bazhong, China.
Front Med (Lausanne). 2025 Jul 8;12:1617194. doi: 10.3389/fmed.2025.1617194. eCollection 2025.
This study aimed to compare the perioperative outcomes of single-incision laparoscopic surgery (SILS) and dual-port laparoscopic myomectomy in patients with solitary uterine fibroids.
This retrospective observational study included 162 patients who underwent laparoscopic myomectomy for solitary fibroids from January 2022 to December 2023 at a single tertiary center. Patients were divided into a SILS group ( = 77) and a dual-port group ( = 85). Perioperative outcomes-including operative time, intraoperative blood loss, analgesic use, hospital stay, and cosmetic results-were compared between the groups. Multivariate linear and logistic regression analyses were conducted to identify factors associated with surgical complexity and recovery.
The dual-port group had significantly lower intraoperative blood loss (41.71 ± 65.37 mL vs. 89.55 ± 93.70 mL, < 0.001), lower rates of postoperative analgesic use (24.7% vs. 40.3%, = 0.034), and shorter hospital stays (1.07 ± 0.30 vs. 1.30 ± 0.65 days, = 0.005) compared to the SILS group. Fibroid size and procedure time were independent predictors of increased bleeding. Posterior wall fibroids were significantly associated with postoperative analgesic use. Delayed discharge was more common in patients with larger fibroids and those requiring postoperative analgesia. Cosmetic outcomes in the dual-port group remained favorable despite the auxiliary incision.
Dual-port laparoscopic myomectomy is a feasible and potentially more effective alternative to single-incision surgery, offering better ergonomic access, improved perioperative outcomes, and excellent cosmetic results. This approach may be especially advantageous when addressing large or posteriorly located fibroids. Individualized surgical planning remains essential to optimize outcomes in minimally invasive myomectomy.
本研究旨在比较单孔腹腔镜手术（SILS）与双孔腹腔镜子宫肌瘤切除术治疗孤立性子宫肌瘤患者的围手术期结局。
这项回顾性观察性研究纳入了2022年1月至2023年12月在一家三级中心接受腹腔镜子宫肌瘤切除术治疗孤立性肌瘤的162例患者。患者分为SILS组（n = 77）和双孔组（n = 85）。比较两组的围手术期结局，包括手术时间、术中出血量、镇痛药物使用情况、住院时间和美容效果。进行多因素线性和逻辑回归分析以确定与手术复杂性和恢复相关的因素。
与SILS组相比，双孔组术中出血量显著更低（41.71±65.37 mL vs. 89.55±93.70 mL，P<0.001），术后镇痛药物使用率更低（24.7% vs. 40.3%，P = 0.034），住院时间更短（1.07±0.30 vs. 1.30±0.65天，P = 0.005）。肌瘤大小和手术时间是出血增加的独立预测因素。后壁肌瘤与术后镇痛药物使用显著相关。肌瘤较大和需要术后镇痛的患者延迟出院更为常见。尽管有辅助切口，双孔组的美容效果仍然良好。
双孔腹腔镜子宫肌瘤切除术是单孔手术可行且可能更有效的替代方法，具有更好的人体工程学操作空间、改善的围手术期结局和出色的美容效果。在处理较大或位于后壁的肌瘤时，这种方法可能特别有利。个体化手术规划对于优化微创子宫肌瘤切除术的结局仍然至关重要。
