Assessing adequacy of cervical core specimens from extirpated uteri: implications for laparoscopic supracervical hysterectomy with transcervical coring.

STUDY OBJECTIVE

To describe the histopathologic adequacy of cervical specimens after ex vivo excision of the cervical canal with cervical coring.

DESIGN

Descriptive study (Canadian Task Force classification III).

SETTING

Community medical center with university affiliation.

INTERVENTION

Endocervical coring.

MEASUREMENTS AND MAIN RESULTS

Eleven cervical core samples from hysterectomy specimens were evaluated. Cervical coring was performed using classic intrafascial supracervical hysterectomy instruments: 15 mm for 6 specimens and 20 mm for 5 specimens. Mean patient age was 49 years, and median (range) parity was 2 (0-3). Three patients (27.3%) were postmenopausal. In most patients (72.7%) leiomyomas and abnormal uterine bleeding was the indication for hysterectomy, and 3 patients (23.3%) had uterovaginal prolapse. The most common cervical pathologic diagnosis was chronic cystic cervicitis (72.7%). Histopathologic presence of the entire cervical transformation zone was present in all 11 cervical core samples. Endocervical glands were absent in the radial margins of all samples. Endometrial glands were absent in the radial margins in 7 samples (63.6%). There was no statistically significant difference in age, parity, cervical remnant, and cervical core dimensions between both core sizes (p > .05).

CONCLUSION

Cervical coring to remove the endocervical canal during hysterectomy resulted in adequate removal of endocervical glands and endometrial glands in most cases, using either the 15-mm or 20-mm classic intrafascial supracervical hysterectomy instrument.