Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex

Objective: To measure the incidence of unanticipated gynecologic malignancies among women who underwent hysterectomy for benign indications. Methods: We conducted a data analysis of hysterectomy cases from the medical files as well as from pathology reports in the pathology department in Al Shifa Me...

Full description

Bibliographic Details
Main Authors: Samar M. AbuSaqer, Abdalla I.H.Abu Shammala, Sewar Elejla, Hani Mahdi, Raghda Abu Laban, Hosam AA. Hamada, Mohammed W. Zimmo
Format: Article
Language:English
Published: Elsevier 2023-01-01
Series:Cancer Treatment and Research Communications
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468294223000187
_version_ 1797828140744048640
author Samar M. AbuSaqer
Abdalla I.H.Abu Shammala
Sewar Elejla
Hani Mahdi
Raghda Abu Laban
Hosam AA. Hamada
Mohammed W. Zimmo
author_facet Samar M. AbuSaqer
Abdalla I.H.Abu Shammala
Sewar Elejla
Hani Mahdi
Raghda Abu Laban
Hosam AA. Hamada
Mohammed W. Zimmo
author_sort Samar M. AbuSaqer
collection DOAJ
description Objective: To measure the incidence of unanticipated gynecologic malignancies among women who underwent hysterectomy for benign indications. Methods: We conducted a data analysis of hysterectomy cases from the medical files as well as from pathology reports in the pathology department in Al Shifa Medical Complex. Cases were abstracted from 1st January 2019 to 30th December 2020. Preoperative surgical indications included abnormal uterine bleeding (AUB), fibroid, endometrial malignancy, ovarian mass, prolapse, molar pregnancy, and adenomyosis. Results: During the study period, 195 women underwent a hysterectomy. More than 50% were performed for fibroid and abnormal uterine bleeding (AUB). The incidence of unanticipated gynecologic malignancy among hysterectomies performed for benign indications was 3.06% (6 cases). Three of them underwent hysterectomy due to post-menopausal bleeding with no preoperative endometrial sampling. Main risk factor were age, anemia, previous medical disorder, lack of equipments, and insufficient preoperative investigations or risks assessments that we considered it an important factor for the development and concealment of pre-existing malignant growth which will lead to future complicated medical plan and management to control the situation. Conclusion: Unanticipated pathology in this study was mainly due to incomplete preoperative assessment and workup including diagnostic imaging modalities and D&C biopsy. This workup should be done for all cases before hysterectomy, especially in old-age women with postmenopausal bleeding. Our study indicates that even in cases that are expected to be benign, nothing should be overlooked, and detailed preoperative evaluations should be performed.
first_indexed 2024-04-09T12:59:51Z
format Article
id doaj.art-be68287484854920b81975e425b12967
institution Directory Open Access Journal
issn 2468-2942
language English
last_indexed 2024-04-09T12:59:51Z
publishDate 2023-01-01
publisher Elsevier
record_format Article
series Cancer Treatment and Research Communications
spelling doaj.art-be68287484854920b81975e425b129672023-05-13T04:25:30ZengElsevierCancer Treatment and Research Communications2468-29422023-01-0135100697Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical ComplexSamar M. AbuSaqer0Abdalla I.H.Abu Shammala1Sewar Elejla2Hani Mahdi3Raghda Abu Laban4Hosam AA. Hamada5Mohammed W. Zimmo6Al-Azher University branch, Al-Quds University, Gaza, Palestine; Corresponding author.Al-Azher University branch, Al-Quds University, Gaza, PalestineAl-Azher University branch, Al-Quds University, Gaza, PalestineHead manager of obstetrics hospital, Al Shifa Medical Complex, Gaza PalestineHead of Obstetrics Department, Al Shifa medical complex, Gaza, PalestineHead of pathology department. Al-shifa medical complex, Gaza, PalestineObstetrics Department, Al Shifa medical complex, Gaza, Palestine; Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, NorwayObjective: To measure the incidence of unanticipated gynecologic malignancies among women who underwent hysterectomy for benign indications. Methods: We conducted a data analysis of hysterectomy cases from the medical files as well as from pathology reports in the pathology department in Al Shifa Medical Complex. Cases were abstracted from 1st January 2019 to 30th December 2020. Preoperative surgical indications included abnormal uterine bleeding (AUB), fibroid, endometrial malignancy, ovarian mass, prolapse, molar pregnancy, and adenomyosis. Results: During the study period, 195 women underwent a hysterectomy. More than 50% were performed for fibroid and abnormal uterine bleeding (AUB). The incidence of unanticipated gynecologic malignancy among hysterectomies performed for benign indications was 3.06% (6 cases). Three of them underwent hysterectomy due to post-menopausal bleeding with no preoperative endometrial sampling. Main risk factor were age, anemia, previous medical disorder, lack of equipments, and insufficient preoperative investigations or risks assessments that we considered it an important factor for the development and concealment of pre-existing malignant growth which will lead to future complicated medical plan and management to control the situation. Conclusion: Unanticipated pathology in this study was mainly due to incomplete preoperative assessment and workup including diagnostic imaging modalities and D&C biopsy. This workup should be done for all cases before hysterectomy, especially in old-age women with postmenopausal bleeding. Our study indicates that even in cases that are expected to be benign, nothing should be overlooked, and detailed preoperative evaluations should be performed.http://www.sciencedirect.com/science/article/pii/S2468294223000187HysterectomyAbnormal uterine bleedingIndicationsD&C biopsyUnanticipated pathologyMalignancy
spellingShingle Samar M. AbuSaqer
Abdalla I.H.Abu Shammala
Sewar Elejla
Hani Mahdi
Raghda Abu Laban
Hosam AA. Hamada
Mohammed W. Zimmo
Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex
Cancer Treatment and Research Communications
Hysterectomy
Abnormal uterine bleeding
Indications
D&C biopsy
Unanticipated pathology
Malignancy
title Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex
title_full Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex
title_fullStr Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex
title_full_unstemmed Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex
title_short Incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross-section study in Al Shifa Medical Complex
title_sort incidence and risk factors of unanticipated pathology in cases of hysterectomy for benign lesion a cross section study in al shifa medical complex
topic Hysterectomy
Abnormal uterine bleeding
Indications
D&C biopsy
Unanticipated pathology
Malignancy
url http://www.sciencedirect.com/science/article/pii/S2468294223000187
work_keys_str_mv AT samarmabusaqer incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex
AT abdallaihabushammala incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex
AT sewarelejla incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex
AT hanimahdi incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex
AT raghdaabulaban incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex
AT hosamaahamada incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex
AT mohammedwzimmo incidenceandriskfactorsofunanticipatedpathologyincasesofhysterectomyforbenignlesionacrosssectionstudyinalshifamedicalcomplex