Parker William, Pritts Elizabeth, Olive David
University of California San Diego, San Diego, California.
Wisconsin Fertility Institute, Middleton, Wisconsin.
Clin Obstet Gynecol. 2019 Dec;62(4):727-732. doi: 10.1097/GRF.0000000000000485.
Morcellation is necessary for many women with fibroids who choose to undergo laparoscopic myomectomy or hysterectomy. After open and laparoscopic myomectomy, myometrial cells can be detected in the abdomen and pelvis. After morcellation, careful inspection for and removal of tissue fragments and copious irrigation and suctioning of fluid can remove residual tissue with or without the use of containment bags. Leiomyosarcoma has a poor prognosis because of early hematogenous metastasis and has a high propensity for recurrence despite the performance of total abdominal hysterectomy. Eliminating residual tissue in the pelvis and abdomen should be the goal after morcellation.
对于许多选择接受腹腔镜子宫肌瘤切除术或子宫切除术的子宫肌瘤女性患者来说,肌瘤粉碎术是必要的。在开放性和腹腔镜子宫肌瘤切除术后,可在腹部和盆腔检测到子宫肌层细胞。肌瘤粉碎术后,仔细检查并清除组织碎片,大量冲洗和抽吸液体,无论是否使用 containment bags,都可以清除残留组织。平滑肌肉瘤预后较差,因为早期会发生血行转移,尽管进行了全腹子宫切除术,仍有很高的复发倾向。肌瘤粉碎术后的目标应该是清除盆腔和腹部的残留组织。