Comparison of Transumbilical Single‑Port and Multi‑Port Laparoscopic Myomectomy in Patients with Uterine Fibroids: Effects on Stress Response, Immune Function, and Incision Cosmetic Outcomes.

Abstract

Objective: This study compared the effects of transumbilical single‑port laparoscopic myomectomy (SPLM) and multi‑port laparoscopic myomectomy (MPLM) on stress response, immune function, and incision cosmetic outcomes in patients with uterine fibroids (UFs).

Methods: A total of 146 UF patients were randomized to receive SPLM (n = 73) or MPLM (n = 73). Outcome measures included perioperative indicators, stress markers, immune parameters, ovarian function, incision cosmetic outcomes, postoperative complication rate, menstrual normalization, and recurrence.

Results: The SPLM group had longer operative time and shorter postoperative exhaustion and hospitalization than the MPLM group (P < 0.05). At 3 days postoperatively, the SPLM group showed higher SOD, CD3⁺, and CD4⁺/CD8⁺ levels and lower MDA and ROS levels than the MPLM group (P < 0.05). At 3 months postoperatively, no significant differences were observed in AMH, LH, or FSH levels between the two groups (P > 0.05). The SPLM group showed higher CS scores and lower BIS scores compared with the MPLM group (P < 0.05). The rates of complications, menstrual recovery, and recurrence were comparable (P > 0.05).

Conclusion: Compared with MPLM, SPLM showed better effects in reducing oxidative stress, maintaining immune function, and improving incision cosmetic outcomes for patients with UFs.