Alqahtani Nourah Hasan, Albayat Methal I, Al Nashwan Yara A, Alnemer Areej Manssour
Department of Obstetrics and Gynecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Saudi J Med Med Sci. 2023 Jul-Sep;11(3):257-263. doi: 10.4103/sjmms.sjmms_438_22. Epub 2023 Jul 15.
Hysterectomies are increasingly being replaced by more conservative management modalities and are now only used for limited clinical indications. The agreement between these indications and the final pathology is understudied.
This study aimed to correlate the preoperative clinical diagnoses with the pathological findings detected in hysterectomies in Saudi women of different age groups.
This retrospective study analyzed the preoperative clinical indications and the subsequent clinical and pathological data of all hysterectomies conducted at a single tertiary care hospital in the Eastern Province of Saudi Arabia between January 2010 and December 2021.
There was no decline in the frequency of hysterectomies across the study period. Abnormal uterine bleeding was the most common clinical indication across all age groups, followed by symptomatic fibroid and uterine prolapse in women aged <50 and ≥50 years, respectively. A total of 9.2% of the cases were indicated for therapeutic reasons, either as an emergency procedure for peripartum hemorrhage or for suspected uterine premalignant and malignant lesions. Besides these, 41.2% of patients had more than one pathology, with the most common combination being leiomyoma and adenomyosis (43.4%). The difference in age between malignant and benign cases (52.3 vs. 48.8 years, respectively) was not statistically significant ( = 0.109).
Most of our cohort had benign lesions. Perceptible misuse of the procedure in this cohort was unlikely, as a large proportion of the patients had more than one pathology corresponding to each clinical indication.
子宫切除术正越来越多地被更保守的治疗方式所取代，目前仅用于有限的临床指征。这些指征与最终病理结果之间的一致性研究较少。
本研究旨在将不同年龄组沙特女性子宫切除术中的术前临床诊断与病理结果进行关联。
这项回顾性研究分析了2010年1月至2021年12月在沙特阿拉伯东部省一家三级医疗中心进行的所有子宫切除术的术前临床指征以及随后的临床和病理数据。
在研究期间，子宫切除术的频率没有下降。异常子宫出血是所有年龄组最常见的临床指征，其次是年龄<50岁和≥50岁女性中分别出现的有症状子宫肌瘤和子宫脱垂。共有9.2%的病例是出于治疗目的，要么作为产后出血的紧急手术，要么是针对疑似子宫癌前病变和恶性病变。除此之外，41.2%的患者有不止一种病理情况，最常见的组合是平滑肌瘤和子宫腺肌病（43.4%）。恶性和良性病例的年龄差异（分别为52.3岁和48.8岁）无统计学意义（P = 0.109）。
我们队列中的大多数患者患有良性病变。该队列中不太可能存在明显的手术滥用情况，因为很大一部分患者的每种临床指征都对应不止一种病理情况。
