Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Gynecological Procedures & Undetected Cancer

A look at power morcellation

The development of alternative techniques, such as power morcellation, to allow surgeons to perform minimally invasive procedures while avoiding iatrogenic dissemination of cancer, may significantly benefit patients, according to a study of women undergoing either laparoscopic supracertical hysterectomy (n=17,903) and laparoscopic myomectomy (n=1,603). Researchers found:

• The rate of uterine cancer among women undergoing hysterectomy was 2.96 per 1,000 and increased with age from 0 per 1,000 at age <35 years to 9.07 per 1,000 at ages 55 to 64 years.

• Preoperative endometrial biopsy was documented in 47% of women subsequently diagnosed with uterine cancer.

• Overall rate of malignant and premalignant gynecological conditions was 5.14 per 1,000 for laparoscopic supracervical hysterectomy and 1.87 per 1,000 for laparoscopic myomectomy.

Citation: Perkins RB, Handal-Orefice R, Hanchate AD, Lin M, Paasche-Orlow MK. Risk of undetected cancer at the time of laparoscopic supracervical hysterectomy and laparoscopic myomectomy: implications for the use of power morcellation. [Published online ahead of print November 19, 2015]. Women’s Health Issues. doi: 10.1016/j.whi.2015.09.008.