Application value of laparo-endoscopic single-site surgery during the second and third trimesters complicated with gynecological pelvic mass

Objective The aim of the present retrospective cohort study was to compare the clinical characteristics, perioperative outcomes and pregnancy outcomes of laparo-endoscopic single-site (LESS) surgery, conventional laparoscopy (CL) surgery and transabdominal (TA) surgery for managing gynecological pelvic masses (GPMs) during the second (14–28 weeks) and third (> 28 weeks) trimesters. The study comprised patients who underwent surgical intervention (LESS, CL or TA surgery) for GPMs at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Shannan Maternal and Child Health Hospital, and Zhongnan Hospital of Wuhan University, between June 2018 and June 2023. Design Retrospective cohort study. Setting Multicenter academic healthcare institutions. Participants Patients undergoing surgical intervention for GPM at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Shannan Maternal and Child Health Hospital, and Zhongnan Hospital of Wuhan University, between June 2018 and June 2023. Interventions LESS, CL, or TA. Results Among the 59 patients (gestational age: 13–29 weeks, including one case of twin pregnancy), 16 underwent LESS surgery, 25 underwent CL surgery, and 18 underwent TA surgery. Compared to the TA group, the laparoscopic group (LESS and CL surgeries) had shorter operative times and bed rest durations, lower inflammatory markers, and a reduced length of hospital stay post-operation. The LESS surgery group was noted to have lower VAS pain scores and lower SCAR scores at one month post-surgery compared with the CL group. However, there were no statistically significant differences in infant growth and neurodevelopmental outcomes at one year of age among the three groups. Conclusions The present study has shown that LESS surgery presents a safe and effective alternative for managing GPMs during the second and third trimesters, offering advantages in terms of postoperative recovery and scar appearance.