Nonmalignant Sequelae of Unconfined Morcellation at Laparoscopic Hysterectomy or Myomectomy

Togas Tulandi, Tulandi T, Annie Leung, Leung A, Jan N, Noran Jan
Journal of Minimally Invasive Gynecology · 2016 · vol. 23(3) , pp. 331–337 · doi:10.1016/j.jmig.2016.01.017 · PMID:26802909 · W2274207808
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This paper investigated nonmalignant complications of unconfined morcellation during laparoscopic hysterectomy and myomectomy procedures.

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Abstract

The objective of this study was to evaluate nonmalignant sequelae of unconfined morcellation at hysterectomy and myomectomy. We performed a systematic review following the PRISMA statement key words of "morcellation, uterine leiomyoma, uterine fibroid, laparoscopic myomectomy, laparoscopic total hysterectomy, and laparoscopic supracervical hysterectomy" and their combination. Fifty-one articles met the inclusion criteria: 11 articles were related to endometriosis, adenomyosis, and endometrial hyperplasia; 30 articles parasitic myoma; and 9 disseminated peritoneal leiomyomatosis (DPL) and 1 DPL and endometriosis. We found that laparoscopic hysterectomy or myomectomy with unconfined morcellation is associated with the risk of iatrogenic endometriosis (1.4%), adenomyosis (0.57%), parasitic myoma (0.9%), and rarely DPL. Our study showed that benign sequelae of uterine or myoma morcellation could be found in up to 1% of cases. This is much higher than the prevalence of uterine sarcoma after morcellation. Benign conditions have less consequences than malignancy, yet they are more common and might require another operation. Accordingly, if morcellation is required, confined morcellation should be considered.

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Condition tags

endometriosis

MeSH descriptors

Adenomyosis Endometriosis Hysterectomy Laparoscopy Leiomyoma Morcellation Uterine Myomectomy Uterine Neoplasms Adenomyosis Adenomyosis Adult Endometriosis Endometriosis Female Humans Hysterectomy Laparoscopy Leiomyoma Leiomyoma Morcellation

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (7)

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