Department of Gynecology and Obstetrics, Agatharied Hospital, Norbert-Kerkel-Platz, 83734 Hausham, Germany.
Academic Teaching Hospital, Ludwig-Maximilian University of Munich (LMU), Munich, Germany.
Biomed Res Int. 2017;2017:6701916. doi: 10.1155/2017/6701916. Epub 2017 Nov 29.
Tissue morcellation during laparoscopic hysterectomy carries the risk of spreading cells from unsuspected malignancy. Contained morcellation inside a bag is supposed to minimize this risk. The present study evaluated routine use of in-bag morcellation during laparoscopic hysterectomy in a consecutive patient cohort ( = 49). The system used was More-Cell-Safe (A.M.I. Austria). Median age was 47 (35 to 76) years and BMI 25.1 (18.8 to 39.8). Indications for hysterectomy were fibroids (71.4%), adenomyosis (16.3%), prolapse (8.2%), and bleeding disorders (4.1%). 48 (98%) patients underwent supracervical hysterectomy and 1 (2%) underwent total hysterectomy. No unsuspected malignancy occurred. Median weight of extirpated tissue was 195 g (18 to 1110). Residual tissue and/or fluid in the bag amounted to 29 g (0 to 291). Median overall duration of surgeries was 100.5 min, and median time associated with the use of the bag was 10 min (5 to 28), significantly correlated with uterine volume ( = 0.0094) and specimen weight ( = 0.0002), but not with patient's BMI ( = 0.6970). Technical success rate for contained morcellation was 93.9%. Peritoneal washings after contained morcellation were all negative for malignant or smooth muscle cells.
在腹腔镜子宫切除术中进行组织切碎会增加意外恶性肿瘤细胞播散的风险。将切碎组织置于袋中可以最大限度地降低这种风险。本研究评估了连续患者队列（n=49）中在腹腔镜子宫切除术中常规使用袋内切碎的效果。使用的系统为 More-Cell-Safe（A.M.I. Austria）。中位年龄为 47 岁（35 岁至 76 岁），BMI 为 25.1（18.8 至 39.8）。子宫切除术的指征为肌瘤（71.4%）、腺肌病（16.3%）、脱垂（8.2%）和出血性疾病（4.1%）。48 例（98%）患者行次全子宫切除术，1 例（2%）行全子宫切除术。无意外恶性肿瘤发生。切除组织的中位重量为 195g（18g 至 1110g）。袋中残余组织和/或液体的重量为 29g（0g 至 291g）。手术的总中位时间为 100.5 分钟，使用袋的中位时间为 10 分钟（5 分钟至 28 分钟），与子宫体积（r=0.0094）和标本重量（r=0.0002）显著相关，但与患者 BMI 无关（r=0.6970）。袋内切碎的技术成功率为 93.9%。袋内切碎后腹膜冲洗均未检出恶性或平滑肌细胞。
