Wong Marron, De Wilde Rudy Leon, Isaacson Keith
Newton-Wellesley Hospital, Center for Minimally Invasive Gynecologic Surgery, Harvard Medical School, Newton, MA, USA.
Department of Gynecology, Obstetrics and Gynecological Oncology at Pius Hospital, University Hospital for Gynecology-Carl von Ossietzky University, Oldenburg, Germany.
Arch Gynecol Obstet. 2018 Feb;297(2):285-293. doi: 10.1007/s00404-017-4575-6. Epub 2017 Nov 11.
This review covers the most recent evidence to discuss the incidence of occult uterine sarcoma, whether morcellation increases tumor dissemination or mortality, and whether there is a difference between different types of morcellation. We will also discuss techniques to reduce the spread of an undiagnosed uterine sarcoma.
A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, and Google Scholar for articles related to the incidence of occult uterine sarcoma after morcellation.
Fibroids are benign uterine tumors and are a common indication for gynecologic surgery. Increasingly, gynecologists are approaching these surgeries with minimally invasive techniques. Uterine sarcomas are rare malignant mesenchymal tumors that are difficult to distinguish preoperatively from uterine fibroids.
During a minimally invasive surgery, there is a risk of disseminating an occult sarcoma during tissue extraction. Minimally invasive gynecologists are tasked with balancing taking a minimally invasive approach, which is shown to result in better patient outcomes, with minimizing the risk of spreading an occult sarcoma.
本综述涵盖最新证据，以探讨隐匿性子宫肉瘤的发病率、粉碎术是否会增加肿瘤播散或死亡率，以及不同类型的粉碎术之间是否存在差异。我们还将讨论减少未确诊子宫肉瘤播散的技术。
在PubMed、Medline、Cochrane图书馆和谷歌学术上进行全面的文献检索，以查找与粉碎术后隐匿性子宫肉瘤发病率相关的文章。
子宫肌瘤是良性子宫肿瘤，是妇科手术的常见适应症。越来越多的妇科医生采用微创技术进行这些手术。子宫肉瘤是罕见的恶性间叶性肿瘤，术前难以与子宫肌瘤区分开来。
在微创手术过程中，组织提取过程中存在隐匿性肉瘤播散的风险。微创妇科医生的任务是在采用微创方法（已证明可带来更好的患者预后）与将隐匿性肉瘤播散风险降至最低之间取得平衡。
