AI Article Synopsis
- The study examines the occurrence of hidden malignant mesenchymal tumors in patients undergoing surgery for uterine fibroids, focusing on the surgical method used.
- It involved a retrospective analysis of 803 patients from January 2011 to December 2018, highlighting that most underwent open surgery, with a notable number of laparoscopic and vaginal procedures.
- Results showed a high prevalence of benign tumors, with some malignant cases identified, and indicated that laparoscopic myomectomy is more common among younger patients and is linked to shorter hospital stays, although the risk of unintentionally spreading malignancies exists but is low with proper preoperative evaluations.
Article Abstract
The aim of this study is to investigate the prevalence of occult malignant mesenchymal tumors in patients operated on for uterine fibroids in relation to the surgical approach and type of operation. A retrospective review of all patients that underwent surgery for uterine fibroids (January 2011-December 2018) at the 1st Department of Obstetrics & Gynecology at "Papageorgiou" Hospital. The surgical approach and clinicopathological characteristics were analyzed. A total of 803 patients were operated on: 603 (75.1%) with laparotomy, 187 (23.3%) laparoscopically, and 13 (1.6%) vaginally. Furthermore, 423 (52.7%) patients underwent hysterectomy and 380 (47.3%) myomectomies. Laparoscopy and myomectomy were offered to younger patients with fewer smaller uterine fibroids and were associated with statistically significant shorter hospitalization. The pathological reports revealed: 690 (86%) benign leiomyomas, 32 (4%) cellular leiomyomas, 29 (3.6%) degenerated leiomyomas, 22 (2.7%) adenomyomas, 18 (2.2%) atypical-bizarre leiomyomas, 1 (0.1%) STUMP, 5 (0.65%) endometrial stromal sarcomas, and 6 (0.75%) cases of leiomyosarcomas (LMS). All LMS were preoperatively characterized as suspicious and underwent abdominal hysterectomy. Morcellation was offered in two cases of atypical leiomyomas, with no morcellation-associated complication. Laparoscopy as a valuable surgical approach for young patients with fewer in number and smaller in size fibroids is associated with shorter hospitalization. The risk of unintended morcellation of LMS seems to be very low and can be reduced with careful preoperative work-up but not eliminated.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10743724 | PMC |
| http://dx.doi.org/10.3390/jcm12247555 | DOI Listing |
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