ORIGINAL RESEARCH article
Front. Surg.
Sec. Obstetrics and Gynecological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1568000
This article is part of the Research TopicAdvancements in Diagnostic and Management Strategies for Gynecological PathologiesView all 21 articles
Comparison of the Perioperative Complications of High Intensity Focused Ultrasound (HIFU) versus Laparoscopic Surgery for Uterine Fibroids: A retrospective study
Provisionally accepted
- 1首都医科大学附属北京安贞医院南充市中心医院, 南充市, China
- 2川北医学院附属医院, 南充市, China
- 3上海市第一妇幼保健院, 上海市, China
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Objective: To compare the perioperative complications following high intensity focused ultrasound (HIFU) or laparoscopic surgery for uterine fibroids.Methods: A retrospective cohort was conducted involving patients with uterine fibroids (UFs) who underwent HIFU or laparoscopic surgery. The primary outcome was the incidence of perioperative complications. Secondary outcomes included the Numerical Rating Scale (NRS) for pain assessment, duration of hospital stay, hospitalization costs, and the incidence of short-term postoperative complications within one month. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors.Results: A total of 140 patients were included in the study, with an overall perioperative complication rate of 73.0%. Among them, 46 patients underwent HIFU treatment, while 94 underwent laparoscopic surgery. The HIFU group experienced significantly fewer total complications (52.2% vs. 83.0%, P<0.001) and grade ≥II complications (4.4% vs. 26.6%, P=0.021) compared to the laparoscopic group. Further multivariate logistic regression revealed that treatment modality (Laparoscopic Surgery vs. HIFU: OR 5.48, 95% CI: 1.17-25.65, P=0.031) was independent risk factors for grade ≥II complications. Moreover, the HIFU group also experienced less pain on postoperative day 1, 2, and 3 compared to the laparoscopic surgery group (2.50 vs. 4.00, P<0.001; 1.00 vs. 4.00, P<0.001; 1.00 vs. 3.00, P<0.001; respectively). Additionally, subgroup analyses showed that laparoscopic myomectomy (LM) group had fewer grade ≥II complications than laparoscopic hysterectomy (LH) group (15.4% vs. 40.5%, P=0.006).HIFU treatment is associated with a lower rate of perioperative complications, including grade ≥II complications, reduced postoperative pain, shorter hospital stays, and lower hospitalization costs compared to laparoscopic surgery. These findings suggest that HIFU may serve as a viable alternative strategy for the management of uterine fibroids.
Keywords: High Intensity Focused Ultrasound1, laparoscopic surgery2, perioperative complications3, Clavien-Dindo classification4, Numerical Rating Scale (NRS)5
Received: 28 Jan 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Hu, Fang, Tang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fan Xu, 上海市第一妇幼保健院, 上海市, China
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