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Clinical Outcomes of Single-Port Versus Conventional Multiport Laparoscopic Myomectomy: A Retrospective Study
Yucui Zeng1, Ping Li1, Yushan Li1
1Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China.
Introduction:
To compare the clinical outcomes of laparoscopic myomectomy via single-port approach (SPLM) and conventional multiport laparoscopic myomectomy (MPLM).
Methods:
A retrospective analysis was conducted on 149 patients with uterine fibroids, including 77 who underwent MPLM and 72 who underwent SPLM. Patient baseline characteristics and perioperative indicators were compared to evaluate surgical efficacy.
Results:
No significant differences were observed between the two groups in demographic characteristics, fibroid number, or maximum fibroid diameter (p > 0.05). The SPLM group had a higher proportion of anterior wall fibroids (45.8% vs. 26.0%) and subserosal fibroids (38.9% vs. 18.2%) compared to the MPLM group (p < 0.05). The SPLM group showed significantly better outcomes in total operative time (99.85 ± 33.65 minutes vs. 120.91 ± 49.48 minutes), time to postoperative gastrointestinal recovery (1.40 ± 0.55 days vs. 1.69 ± 0.47 days), and 24-hour postoperative visual analog scale (VAS) score (2.33 ± 0.65 vs. 2.70 ± 0.84) (p < 0.05). No significant differences were found in intraoperative blood loss, postoperative complication rates, or hospital stay between the two groups in the overall analysis. However, based on the four influencing factors, further stratified analysis within each factor revealed that SPLM was more advantageous for treating single fibroids, fibroids less than 8 cm in diameter, and intramural fibroids, demonstrating significantly shorter operative times than MPLM (p < 0.05). Surgeon A demonstrated superior outcomes in both operative time and intraoperative blood loss when performing myomectomy via the single-port laparoscopic approach compared to the multiport technique (p ≤ 0.05).
Conclusion:
SPLM is a safe and effective surgical approach. For single intramural fibroids less than 8 cm in diameter, it demonstrates superior operative efficiency compared to conventional MPLM, particularly regarding operative time. When performed by the senior surgeon, the advantages of SPLM become even more pronounced in both operative duration and intraoperative blood loss.
