{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:05:16Z","timestamp":1776254716332,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of pelvic drainage and postoperative rectal misoprostol on short-term outcomes after laparoscopic myomectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicenter retrospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Five tertiary hospitals in Sichuan Province, China, between January 2021 and June 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Of 302 patients initially identified, 280 met inclusion criteria after exclusions for malignancy, incomplete data, or combined procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Patients were categorized into four groups according to surgical approach (multi-port vs. single-port) and postoperative management strategy, allowing evaluation of the independent effects of pelvic drainage and misoprostol within different surgical contexts. The use of pelvic drainage and rectal misoprostol (400\u202f\u03bcg) was non-randomized and determined by institutional protocol and surgeon discretion. Perioperative parameters\u2014including operative time, blood loss, drainage characteristics, and postoperative recovery\u2014were extracted from electronic medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcomes were postoperative fever and pelvic infection; secondary outcomes included drainage output and duration, postoperative pain, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pelvic drainage did not reduce postoperative fever or pelvic infection. In multivariable logistic regression adjusted for relevant covariates (including age, BMI, parity, prior abdominal surgery, myoma size, number of myomas removed, and use of vasopressin or other hemostatic agents), drain placement independently increased the risk of postoperative fever (adjusted OR\u202f=\u202f2.30, 95% CI 1.10\u20134.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028). In contrast, postoperative rectal administration of misoprostol significantly decreased the risk of postoperative fever (adjusted OR\u202f=\u202f0.53, 95% CI 0.30\u20130.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.031) and pelvic infection (adjusted OR\u202f=\u202f0.36, 95% CI 0.12\u20130.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.043). Among patients with drainage, misoprostol use further reduced total drain volume and duration (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Patients undergoing single-port procedures without drainage also showed low complication rates, with less postoperative pain and shorter hospital stays compared with multi-port cases with drains (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pelvic drainage after laparoscopic myomectomy offers no measurable benefit and may heighten postoperative morbidity. In contrast, adjunctive rectal misoprostol effectively lowers the incidence of postoperative fever and pelvic infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1816198","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:18:47Z","timestamp":1776251927000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Selective drainage and rectal misoprostol after laparoscopic myomectomy: a multicenter retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Qin","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Gynecology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junqiang","family":"Li","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengling","family":"Zhou","sequence":"additional","affiliation":[{"name":"Chengdu Shuangliu District Maternity and Child Health Care Hospital","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Pan","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Luo","sequence":"additional","affiliation":[{"name":"The First People 's Hospital of Neijiang","place":["Neijiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuchuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/AOG.0000000000005748","article-title":"Uterine leiomyomas and reproduction","volume":"145","author":"Pritts","year":"2025","journal-title":"Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"128","DOI":"10.23736\/S2724-606X.24.05494-0","article-title":"Barbed suture in laparoscopic myomectomy","volume":"77","author":"Savasta","year":"2025","journal-title":"Minerva Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.jmig.2024.12.012","article-title":"Conservative treatment of uterine myomas: a network Meta-analysis of randomized controlled studies","volume":"32","author":"Dominoni","year":"2025","journal-title":"J Minim Invasive Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"102970","DOI":"10.1016\/j.jogc.2025.102970","article-title":"Guideline no. 461: the Management of Uterine Fibroids","volume":"47","author":"Chen","year":"2025","journal-title":"J Obstet Gynaecol Can"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.jmig.2024.05.010","article-title":"Operative time and accrual of postoperative complications in minimally invasive versus open myomectomy","volume":"31","author":"Applebaum","year":"2024","journal-title":"J Minim Invasive Gynecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"5485","DOI":"10.1097\/JS9.0000000000002590","article-title":"Laparoendoscopic single site myomectomy versus conventional laparoscopic myomectomy for uterine myomas: a systematic review and meta-analysis","volume":"111","author":"Xie","year":"2025","journal-title":"Int J Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"146","DOI":"10.4103\/gmit.gmit_152_23","article-title":"Myomectomy: choosing the surgical approach - 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