Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation
Objective The purpose of this study was to describe the incidence and risk factors for uterine sarcomas and parasitic myomas at the time of power morcellation. Study Design We performed a retrospective review of 3523 women who underwent laparoscopic hysterectomy from 2001-2012. Univariate analyses w...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2015-05, Vol.212 (5), p.594.e1-594.e10 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Tan-Kim, Jasmine, MD, MAS Hartzell, Katherine A., MD Reinsch, Caryl S., MD O’Day, Cristina H., MD Kennedy, John S., MD Menefee, Shawn A., MD Harrison, Terry A., MD |
| description | Objective The purpose of this study was to describe the incidence and risk factors for uterine sarcomas and parasitic myomas at the time of power morcellation. Study Design We performed a retrospective review of 3523 women who underwent laparoscopic hysterectomy from 2001-2012. Univariate analyses were used for the morcellation cases to identify potential risk factors. Multivariable logistic regression was performed. Results Nine hundred forty-one patients underwent power morcellation at the time of hysterectomy; 10 of 941 patients (1.1%) were diagnosed subsequently with uterine sarcomas or parasitic myomas. The overall incidence of uterine sarcoma was 6 of 941 (0.6%), with a median age of 47 years (range, 41–52 years). There was no association among any of the factors analyzed and uterine sarcoma. Three of 6 patients had sarcoma diagnosed on initial pathologic evaluation of the morcellated specimen; 3 patients had delayed diagnosis of sarcoma with benign disease at the time of the initial procedure (median time to second evaluation, 6 years). For parasitic myomas (n = 4), the median age was 35 years (range, 32–40 years), and the median time to second evaluation was 5 years. On multivariate analysis, age |
| doi_str_mv | 10.1016/j.ajog.2014.12.002 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1677881040</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002937814023795</els_id><sourcerecordid>1677881040</sourcerecordid><originalsourceid>FETCH-LOGICAL-c595t-8d749fd54ffc2e9db149c60df31265c9330eb19d8f18ac43fc4bcf21a02e20613</originalsourceid><addsrcrecordid>eNp9kc1O3TAQha2qFdxSXoAFyrKbpB7H-bGEKlUIChJSF4VlZfnaY3BI4tTOBeXtcXqhiy66sjxzztHMN4ScAC2AQv2lK1Tn7wtGgRfACkrZO7IBKpq8buv2PdnQVMpF2bSH5GOM3fplgh2QQ1ZxIVglNuTX3YzBjZhFFbQfVMzUaLJJBRXd7HQ2LPuiTbKsV6nho_ZT6jwsMdVQz35Ysmc3P2STf06iwQeNfa9m58dP5INVfcTj1_eI3F1e3J5f5Tc_vl-ff7vJdSWqOW9Nw4U1FbdWMxRmC1zomhpbAqsrLcqS4haEaS20SvPSar7VloGiDBmtoTwin_e5U_C_dxhnObj4Z4oR_S5KqJumbYFymqRsL9VpkxjQyim4QYVFApUrVtnJFatcsUpgMkFLptPX_N12QPPX8sYxCc72AkxbPjkMMmqHo0bjVkTSePf__K__2HXvRqdV_4gLxs7vwpj4SZAxGeTP9ZLrXYEncyOq8gXtQp_v</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1677881040</pqid></control><display><type>article</type><title>Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Tan-Kim, Jasmine, MD, MAS ; Hartzell, Katherine A., MD ; Reinsch, Caryl S., MD ; O’Day, Cristina H., MD ; Kennedy, John S., MD ; Menefee, Shawn A., MD ; Harrison, Terry A., MD</creator><creatorcontrib>Tan-Kim, Jasmine, MD, MAS ; Hartzell, Katherine A., MD ; Reinsch, Caryl S., MD ; O’Day, Cristina H., MD ; Kennedy, John S., MD ; Menefee, Shawn A., MD ; Harrison, Terry A., MD</creatorcontrib><description>Objective The purpose of this study was to describe the incidence and risk factors for uterine sarcomas and parasitic myomas at the time of power morcellation. Study Design We performed a retrospective review of 3523 women who underwent laparoscopic hysterectomy from 2001-2012. Univariate analyses were used for the morcellation cases to identify potential risk factors. Multivariable logistic regression was performed. Results Nine hundred forty-one patients underwent power morcellation at the time of hysterectomy; 10 of 941 patients (1.1%) were diagnosed subsequently with uterine sarcomas or parasitic myomas. The overall incidence of uterine sarcoma was 6 of 941 (0.6%), with a median age of 47 years (range, 41–52 years). There was no association among any of the factors analyzed and uterine sarcoma. Three of 6 patients had sarcoma diagnosed on initial pathologic evaluation of the morcellated specimen; 3 patients had delayed diagnosis of sarcoma with benign disease at the time of the initial procedure (median time to second evaluation, 6 years). For parasitic myomas (n = 4), the median age was 35 years (range, 32–40 years), and the median time to second evaluation was 5 years. On multivariate analysis, age <40 years (odds ratio, 26; 95% confidence interval, 2.7015–261.9; P ≤ .01) was associated with higher risk of the development of parasitic myomas. Conclusion Uterine sarcoma was found in 0.6% of patients who underwent power morcellation but was not found to be associated significantly with any preoperative factors. All 6 cases were noted to have apparent fibroid tumors as an indication for their hysterectomy. Age <40 years was a risk factor for parasitic myomas after power morcellation. Patients should be counseled about these complications before power morcellation.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2014.12.002</identifier><identifier>PMID: 25499259</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age Factors ; Female ; Humans ; Hysterectomy - methods ; laparoscopic hysterectomy ; Laparoscopy - methods ; Leiomyoma - pathology ; Leiomyoma - surgery ; Logistic Models ; Middle Aged ; Multivariate Analysis ; Obstetrics and Gynecology ; parasitic myomas ; power morcellation ; Retrospective Studies ; Risk Factors ; Sarcoma - pathology ; Uterine Neoplasms - pathology ; Uterine Neoplasms - surgery ; uterine sarcoma</subject><ispartof>American journal of obstetrics and gynecology, 2015-05, Vol.212 (5), p.594.e1-594.e10</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-8d749fd54ffc2e9db149c60df31265c9330eb19d8f18ac43fc4bcf21a02e20613</citedby><cites>FETCH-LOGICAL-c595t-8d749fd54ffc2e9db149c60df31265c9330eb19d8f18ac43fc4bcf21a02e20613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937814023795$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25499259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan-Kim, Jasmine, MD, MAS</creatorcontrib><creatorcontrib>Hartzell, Katherine A., MD</creatorcontrib><creatorcontrib>Reinsch, Caryl S., MD</creatorcontrib><creatorcontrib>O’Day, Cristina H., MD</creatorcontrib><creatorcontrib>Kennedy, John S., MD</creatorcontrib><creatorcontrib>Menefee, Shawn A., MD</creatorcontrib><creatorcontrib>Harrison, Terry A., MD</creatorcontrib><title>Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective The purpose of this study was to describe the incidence and risk factors for uterine sarcomas and parasitic myomas at the time of power morcellation. Study Design We performed a retrospective review of 3523 women who underwent laparoscopic hysterectomy from 2001-2012. Univariate analyses were used for the morcellation cases to identify potential risk factors. Multivariable logistic regression was performed. Results Nine hundred forty-one patients underwent power morcellation at the time of hysterectomy; 10 of 941 patients (1.1%) were diagnosed subsequently with uterine sarcomas or parasitic myomas. The overall incidence of uterine sarcoma was 6 of 941 (0.6%), with a median age of 47 years (range, 41–52 years). There was no association among any of the factors analyzed and uterine sarcoma. Three of 6 patients had sarcoma diagnosed on initial pathologic evaluation of the morcellated specimen; 3 patients had delayed diagnosis of sarcoma with benign disease at the time of the initial procedure (median time to second evaluation, 6 years). For parasitic myomas (n = 4), the median age was 35 years (range, 32–40 years), and the median time to second evaluation was 5 years. On multivariate analysis, age <40 years (odds ratio, 26; 95% confidence interval, 2.7015–261.9; P ≤ .01) was associated with higher risk of the development of parasitic myomas. Conclusion Uterine sarcoma was found in 0.6% of patients who underwent power morcellation but was not found to be associated significantly with any preoperative factors. All 6 cases were noted to have apparent fibroid tumors as an indication for their hysterectomy. Age <40 years was a risk factor for parasitic myomas after power morcellation. Patients should be counseled about these complications before power morcellation.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Female</subject><subject>Humans</subject><subject>Hysterectomy - methods</subject><subject>laparoscopic hysterectomy</subject><subject>Laparoscopy - methods</subject><subject>Leiomyoma - pathology</subject><subject>Leiomyoma - surgery</subject><subject>Logistic Models</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Obstetrics and Gynecology</subject><subject>parasitic myomas</subject><subject>power morcellation</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sarcoma - pathology</subject><subject>Uterine Neoplasms - pathology</subject><subject>Uterine Neoplasms - surgery</subject><subject>uterine sarcoma</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1O3TAQha2qFdxSXoAFyrKbpB7H-bGEKlUIChJSF4VlZfnaY3BI4tTOBeXtcXqhiy66sjxzztHMN4ScAC2AQv2lK1Tn7wtGgRfACkrZO7IBKpq8buv2PdnQVMpF2bSH5GOM3fplgh2QQ1ZxIVglNuTX3YzBjZhFFbQfVMzUaLJJBRXd7HQ2LPuiTbKsV6nho_ZT6jwsMdVQz35Ysmc3P2STf06iwQeNfa9m58dP5INVfcTj1_eI3F1e3J5f5Tc_vl-ff7vJdSWqOW9Nw4U1FbdWMxRmC1zomhpbAqsrLcqS4haEaS20SvPSar7VloGiDBmtoTwin_e5U_C_dxhnObj4Z4oR_S5KqJumbYFymqRsL9VpkxjQyim4QYVFApUrVtnJFatcsUpgMkFLptPX_N12QPPX8sYxCc72AkxbPjkMMmqHo0bjVkTSePf__K__2HXvRqdV_4gLxs7vwpj4SZAxGeTP9ZLrXYEncyOq8gXtQp_v</recordid><startdate>20150501</startdate><enddate>20150501</enddate><creator>Tan-Kim, Jasmine, MD, MAS</creator><creator>Hartzell, Katherine A., MD</creator><creator>Reinsch, Caryl S., MD</creator><creator>O’Day, Cristina H., MD</creator><creator>Kennedy, John S., MD</creator><creator>Menefee, Shawn A., MD</creator><creator>Harrison, Terry A., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150501</creationdate><title>Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation</title><author>Tan-Kim, Jasmine, MD, MAS ; Hartzell, Katherine A., MD ; Reinsch, Caryl S., MD ; O’Day, Cristina H., MD ; Kennedy, John S., MD ; Menefee, Shawn A., MD ; Harrison, Terry A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c595t-8d749fd54ffc2e9db149c60df31265c9330eb19d8f18ac43fc4bcf21a02e20613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Female</topic><topic>Humans</topic><topic>Hysterectomy - methods</topic><topic>laparoscopic hysterectomy</topic><topic>Laparoscopy - methods</topic><topic>Leiomyoma - pathology</topic><topic>Leiomyoma - surgery</topic><topic>Logistic Models</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Obstetrics and Gynecology</topic><topic>parasitic myomas</topic><topic>power morcellation</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sarcoma - pathology</topic><topic>Uterine Neoplasms - pathology</topic><topic>Uterine Neoplasms - surgery</topic><topic>uterine sarcoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan-Kim, Jasmine, MD, MAS</creatorcontrib><creatorcontrib>Hartzell, Katherine A., MD</creatorcontrib><creatorcontrib>Reinsch, Caryl S., MD</creatorcontrib><creatorcontrib>O’Day, Cristina H., MD</creatorcontrib><creatorcontrib>Kennedy, John S., MD</creatorcontrib><creatorcontrib>Menefee, Shawn A., MD</creatorcontrib><creatorcontrib>Harrison, Terry A., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan-Kim, Jasmine, MD, MAS</au><au>Hartzell, Katherine A., MD</au><au>Reinsch, Caryl S., MD</au><au>O’Day, Cristina H., MD</au><au>Kennedy, John S., MD</au><au>Menefee, Shawn A., MD</au><au>Harrison, Terry A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2015-05-01</date><risdate>2015</risdate><volume>212</volume><issue>5</issue><spage>594.e1</spage><epage>594.e10</epage><pages>594.e1-594.e10</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><abstract>Objective The purpose of this study was to describe the incidence and risk factors for uterine sarcomas and parasitic myomas at the time of power morcellation. Study Design We performed a retrospective review of 3523 women who underwent laparoscopic hysterectomy from 2001-2012. Univariate analyses were used for the morcellation cases to identify potential risk factors. Multivariable logistic regression was performed. Results Nine hundred forty-one patients underwent power morcellation at the time of hysterectomy; 10 of 941 patients (1.1%) were diagnosed subsequently with uterine sarcomas or parasitic myomas. The overall incidence of uterine sarcoma was 6 of 941 (0.6%), with a median age of 47 years (range, 41–52 years). There was no association among any of the factors analyzed and uterine sarcoma. Three of 6 patients had sarcoma diagnosed on initial pathologic evaluation of the morcellated specimen; 3 patients had delayed diagnosis of sarcoma with benign disease at the time of the initial procedure (median time to second evaluation, 6 years). For parasitic myomas (n = 4), the median age was 35 years (range, 32–40 years), and the median time to second evaluation was 5 years. On multivariate analysis, age <40 years (odds ratio, 26; 95% confidence interval, 2.7015–261.9; P ≤ .01) was associated with higher risk of the development of parasitic myomas. Conclusion Uterine sarcoma was found in 0.6% of patients who underwent power morcellation but was not found to be associated significantly with any preoperative factors. All 6 cases were noted to have apparent fibroid tumors as an indication for their hysterectomy. Age <40 years was a risk factor for parasitic myomas after power morcellation. Patients should be counseled about these complications before power morcellation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25499259</pmid><doi>10.1016/j.ajog.2014.12.002</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | American journal of obstetrics and gynecology, 2015-05, Vol.212 (5), p.594.e1-594.e10 |
| issn | 0002-9378 1097-6868 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Age Factors Female Humans Hysterectomy - methods laparoscopic hysterectomy Laparoscopy - methods Leiomyoma - pathology Leiomyoma - surgery Logistic Models Middle Aged Multivariate Analysis Obstetrics and Gynecology parasitic myomas power morcellation Retrospective Studies Risk Factors Sarcoma - pathology Uterine Neoplasms - pathology Uterine Neoplasms - surgery uterine sarcoma |
| title | Uterine sarcomas and parasitic myomas after laparoscopic hysterectomy with power morcellation |
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