Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study

ObjectiveTo compare the perioperative complications following high intensity focused ultrasound (HIFU) or laparoscopic surgery for uterine fibroids.MethodsA retrospective cohort was conducted involving patients with uterine fibroids (UFs) who underwent HIFU or laparoscopic surgery. The primary outco...

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Main Authors: Li Hu, Chunling Fang, Nenghuan Tang, Fan Xu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1568000/full
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author Li Hu
Chunling Fang
Nenghuan Tang
Fan Xu
author_facet Li Hu
Chunling Fang
Nenghuan Tang
Fan Xu
author_sort Li Hu
collection DOAJ
description ObjectiveTo compare the perioperative complications following high intensity focused ultrasound (HIFU) or laparoscopic surgery for uterine fibroids.MethodsA 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 1 month. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors.ResultsA total of 140 patients were included in the study, with an overall perioperative complication rate of 72.9%. 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 (4.3% 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).ConclusionHIFU 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.
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spelling doaj-art-26cead4754b04ce3a128f7d6e43e667e2025-08-20T03:27:57ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-07-011210.3389/fsurg.2025.15680001568000Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective studyLi Hu0Chunling Fang1Nenghuan Tang2Fan Xu3Department of Obstetrics and Gynecology, the Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, ChinaDepartment of Obstetrics and Gynecology, the Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan, ChinaDepartment of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, ChinaDepartment of Gynecology, Shanghai First Maternal and Infant Health Care Hospital, Shanghai, ChinaObjectiveTo compare the perioperative complications following high intensity focused ultrasound (HIFU) or laparoscopic surgery for uterine fibroids.MethodsA 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 1 month. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors.ResultsA total of 140 patients were included in the study, with an overall perioperative complication rate of 72.9%. 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 (4.3% 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).ConclusionHIFU 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.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1568000/fullhigh intensity focused ultrasoundlaparoscopic surgeryperioperative complicationsClavien–Dindo classificationnumerical rating scale (NRS)
spellingShingle Li Hu
Chunling Fang
Nenghuan Tang
Fan Xu
Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study
Frontiers in Surgery
high intensity focused ultrasound
laparoscopic surgery
perioperative complications
Clavien–Dindo classification
numerical rating scale (NRS)
title Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study
title_full Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study
title_fullStr Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study
title_full_unstemmed Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study
title_short Comparison of the perioperative complications of high intensity focused ultrasound vs. laparoscopic surgery for uterine fibroids: a retrospective study
title_sort comparison of the perioperative complications of high intensity focused ultrasound vs laparoscopic surgery for uterine fibroids a retrospective study
topic high intensity focused ultrasound
laparoscopic surgery
perioperative complications
Clavien–Dindo classification
numerical rating scale (NRS)
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1568000/full
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