Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation
The authors reviewed uterine fibroid (UF) morcellation and its potential consequences, notably a hypothetical spread and dissemination of occult uterine leiomyosarcoma (LMS) tissue, evaluating the effect of laparoscopic versus open myomectomies with and without morcellation on patients’ outcomes, as...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/10/10/2087 |
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| author | Radmila Sparić Mladen Andjić Ottavia D’Oria Ivana Babović Zagorka Milovanović Gaetano Panese Martina Licchelli Đina Tomašević Andrea Morciano Andrea Tinelli |
| author_facet | Radmila Sparić Mladen Andjić Ottavia D’Oria Ivana Babović Zagorka Milovanović Gaetano Panese Martina Licchelli Đina Tomašević Andrea Morciano Andrea Tinelli |
| author_sort | Radmila Sparić |
| collection | DOAJ |
| description | The authors reviewed uterine fibroid (UF) morcellation and its potential consequences, notably a hypothetical spread and dissemination of occult uterine leiomyosarcoma (LMS) tissue, evaluating the effect of laparoscopic versus open myomectomies with and without morcellation on patients’ outcomes, as well as related medical-legal issues. MEDLINE and PubMed search was performed for the years 1990–2021, using a combination of keywords on this topic. Relevant articles were identified and included in this narrative review. There is an individual risk, for all patients, for LMS diagnosis after myomectomy. However, the risk for occult LMS diagnosis during a laparoscopic myomectomy is generally reduced when the guidelines of scientific societies are followed, with an overall benefit from the laparoscopic approach with morcellation in appropriate cases. Gynecological societies do not ban morcellation and laparoscopic hysterectomy/myomectomy per se, but recommend their use on the basis of the patients’ clinical characteristics. It is suggested for gynecologists to provide detailed information to patients when obtaining an informed consent for open or laparoscopic hysterectomy/myomectomy. A detailed preoperative assessment of patients and the risk benefit ratio of laparoscopic morcellation of uterine mass could overcome the “a priori” banning of the morcellation technique. |
| first_indexed | 2024-03-09T20:09:27Z |
| format | Article |
| id | doaj.art-1ec0d36fc19e42cf9679a7ec69216e7b |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T20:09:27Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-1ec0d36fc19e42cf9679a7ec69216e7b2023-11-24T00:21:49ZengMDPI AGHealthcare2227-90322022-10-011010208710.3390/healthcare10102087Fibroid Removal after Myomectomy: An Overview on the Problems of Power MorcellationRadmila Sparić0Mladen Andjić1Ottavia D’Oria2Ivana Babović3Zagorka Milovanović4Gaetano Panese5Martina Licchelli6Đina Tomašević7Andrea Morciano8Andrea Tinelli9Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, 11000 Belgrade, SerbiaDepartment of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology”, Sapienza University, 00185 Rome, ItalyClinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, Narodni Front, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaDepartment of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), “Veris delli Ponti Hospital”, Scorrano, 73020 Lecce, ItalyDepartment of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), “Veris delli Ponti Hospital”, Scorrano, 73020 Lecce, ItalyDepartment of General Surgery and Pediatric Surgery, General Hospital “Čačak”, 32000 Čačak, SerbiaDepartment of Obstetrics and Gynecology, “Cardinal Panico” Hospital, 73039 Tricase, ItalyDepartment of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), “Veris delli Ponti Hospital”, Scorrano, 73020 Lecce, ItalyThe authors reviewed uterine fibroid (UF) morcellation and its potential consequences, notably a hypothetical spread and dissemination of occult uterine leiomyosarcoma (LMS) tissue, evaluating the effect of laparoscopic versus open myomectomies with and without morcellation on patients’ outcomes, as well as related medical-legal issues. MEDLINE and PubMed search was performed for the years 1990–2021, using a combination of keywords on this topic. Relevant articles were identified and included in this narrative review. There is an individual risk, for all patients, for LMS diagnosis after myomectomy. However, the risk for occult LMS diagnosis during a laparoscopic myomectomy is generally reduced when the guidelines of scientific societies are followed, with an overall benefit from the laparoscopic approach with morcellation in appropriate cases. Gynecological societies do not ban morcellation and laparoscopic hysterectomy/myomectomy per se, but recommend their use on the basis of the patients’ clinical characteristics. It is suggested for gynecologists to provide detailed information to patients when obtaining an informed consent for open or laparoscopic hysterectomy/myomectomy. A detailed preoperative assessment of patients and the risk benefit ratio of laparoscopic morcellation of uterine mass could overcome the “a priori” banning of the morcellation technique.https://www.mdpi.com/2227-9032/10/10/2087uterine fibroidmorcellationoccult leiomyosarcomaopen myomectomylaparoscopic myomectomy |
| spellingShingle | Radmila Sparić Mladen Andjić Ottavia D’Oria Ivana Babović Zagorka Milovanović Gaetano Panese Martina Licchelli Đina Tomašević Andrea Morciano Andrea Tinelli Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation Healthcare uterine fibroid morcellation occult leiomyosarcoma open myomectomy laparoscopic myomectomy |
| title | Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation |
| title_full | Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation |
| title_fullStr | Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation |
| title_full_unstemmed | Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation |
| title_short | Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation |
| title_sort | fibroid removal after myomectomy an overview on the problems of power morcellation |
| topic | uterine fibroid morcellation occult leiomyosarcoma open myomectomy laparoscopic myomectomy |
| url | https://www.mdpi.com/2227-9032/10/10/2087 |
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