Nonmalignant Sequelae of Unconfined Morcellation at Laparoscopic Hysterectomy or Myomectomy

Journal of Minimally Invasive Gynecology
Togas TulandiNoran Jan

Abstract

The objective of this study was to evaluate nonmalignant sequelae of unconfined morcellation at hysterectomy and myomectomy. We performed a systematic review following the PRISMA statement key words of "morcellation, uterine leiomyoma, uterine fibroid, laparoscopic myomectomy, laparoscopic total hysterectomy, and laparoscopic supracervical hysterectomy" and their combination. Fifty-one articles met the inclusion criteria: 11 articles were related to endometriosis, adenomyosis, and endometrial hyperplasia; 30 articles parasitic myoma; and 9 disseminated peritoneal leiomyomatosis (DPL) and 1 DPL and endometriosis. We found that laparoscopic hysterectomy or myomectomy with unconfined morcellation is associated with the risk of iatrogenic endometriosis (1.4%), adenomyosis (0.57%), parasitic myoma (0.9%), and rarely DPL. Our study showed that benign sequelae of uterine or myoma morcellation could be found in up to 1% of cases. This is much higher than the prevalence of uterine sarcoma after morcellation. Benign conditions have less consequences than malignancy, yet they are more common and might require another operation. Accordingly, if morcellation is required, confined morcellation should be considered.

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Citations

Sep 22, 2016·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Miroslav SekulicSaeid Movahedi-Lankarani
Nov 8, 2017·Obstetrics and Gynecology·Matthew T Siedhoff, Sarah L Cohen
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Feb 18, 2021·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice

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