Single-port laparoscopic surgery versus laparotomy for treatment of ovarian cysts ≥ 5 cm in the first and early second trimester of pregnancy: a retrospective comparative study

To investigate the safety and feasibility of single-port access laparoscopic for the surgery treatment of ovarian cysts (maximal diameter ≥ 5 cm) during pregnancy. In this retrospective cohort study, 12 pregnant patients who underwent single-port access laparoendoscopic single-site (LESS) surgery (Group 2) for ovarian cysts between January 2021 and July 2022 were compared with 16 pregnant patients who underwent laparotomy during the same period (Group 1). We retrospectively analyzed clinical characteristics and perioperative outcomes, including age, body mass index, cyst size and pathology, operative time, estimated blood loss (EBL), and postoperative length of hospital stay. No statistically significant differences were observed in baseline characteristics between the two groups. Operative time was significantly shorter in group 2 than in group 1 (56.00 ± 15.06 vs. 95.31 ± 17.82 min, p < 0.001). Estimated blood loss was significantly lower in group 2 than in group 1 (12.08 ± 6.20 vs. 33.13 ± 19.57mL, p < 0.001). Mean hospital stay was shorter in group 2 (4.00 ± 0.95 vs. 7.88 ± 0.96 days, p < 0.001). In this small retrospective cohort, LESS appeared feasible for selected pregnant patients with ovarian cysts (maximal diameter ≥ 5 cm) and was associated with less blood loss and shorter hospitalization than laparotomy. These findings should be interpreted cautiously given the non-randomized design and limited sample size.