Vallabh-Patel Vaneesha, Saiz Cristina, Salamon Charbel, Francis Amanda, Pagnillo Jennifer, Culligan Patrick
From the Atlantic Health System, Division of Urogynecology and Reconstructive Pelvic Surgery, Morristown, NJ.
Female Pelvic Med Reconstr Surg. 2016 Jul-Aug;22(4):190-3. doi: 10.1097/SPV.0000000000000257.
This study aimed to determine the prevalence of occult malignancy found in morcellated specimens removed in the context of pelvic organ prolapse repair operations.
A total of 786 cases were reviewed from a single health system between October 2006 and July 2015. Thorough chart reviews were performed to include pathological specimens. Demographic, perioperative, and postoperative data were collected.
Four occult malignancies were identified including 3 endometrial adenocarcinomas of the uterus and 1 papillary serous carcinoma of the uterus. The overall prevalence of occult malignancy within morcellated specimens was 0.5% (4 of 786). On adopting universal screening with endometrial biopsy, 5 malignancies were identified (5 of 176) before morcellation and no postoperative malignancies in the remaining patients.
Power morcellation is a low-risk procedure with laparoscopic supracervical hysterectomy and sacrocolpopexy. Universal screening is highly effective in detecting occult malignancy and in our small series eliminated the risk; studies in multiple institutions will be needed to determine its effectiveness in other hospital systems.
本研究旨在确定在盆腔器官脱垂修复手术中切除的粉碎标本中隐匿性恶性肿瘤的患病率。
回顾了2006年10月至2015年7月间来自单一医疗系统的786例病例。对病理标本进行了全面的病历审查。收集了人口统计学、围手术期和术后数据。
共发现4例隐匿性恶性肿瘤，包括3例子宫子宫内膜腺癌和1例子宫乳头状浆液性癌。粉碎标本中隐匿性恶性肿瘤的总体患病率为0.5%（786例中的4例）。采用子宫内膜活检进行普遍筛查时，在粉碎术前发现5例恶性肿瘤（176例中的5例），其余患者术后未发现恶性肿瘤。
对于腹腔镜次全子宫切除术和骶骨阴道固定术，电动粉碎术是一种低风险的手术。普遍筛查在检测隐匿性恶性肿瘤方面非常有效，在我们的小样本系列中消除了风险；需要在多个机构进行研究以确定其在其他医院系统中的有效性。
