Abstract
Objective This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. Study design The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment. A literature search within the Medline/PubMed and Cochrane Database was carried out using keywords “morcellation”, “uterine fibroids”, “uterine sarcoma”, “myomectomy” and “hysterectomy”. Relevant publications (original studies, meta-analyses and previous reviews), written in English and published until May 30th, 2017, were selected and analyzed. Previously emitted statements of 12 recognized professional societies or government institutions and their supporting literature were also studied. For each topic/clinical question, the available information was graded by the level of evidence. The ISGE recommendations were established in accordance with the evidence quality. Results In the light of available information, 9 recommendations on preoperative clinical, laboratorial and imaging evaluation of the candidates for intracorporeal uterus/leiomyoma morcellation were formulated, mainly based on consensus and expert opinions. There is a lack of high-quality evidence, which does not allow the establishment of strong recommendations. Conclusion Electromechanical tissue morcellation may be used in gynecological patients who are considered “low risk” upon appropriate preoperative evaluation; however, further studies and prospective data collection are greatly needed to improve sarcoma risk assessment in women with presumed uterine leiomyomas.
| Original language | English |
|---|---|
| Pages (from-to) | 30-38 |
| Number of pages | 9 |
| Journal | European Journal of Obstetrics Gynecology and Reproductive Biology |
| Volume | 220 |
| DOIs | |
| Publication status | Published - Jan 2018 |
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Keywords
- Power morcellation
- Preoperative assessment
- Uterine leiomyoma
- Uterine leiomyosarcoma
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Assessing the risk of laparoscopic morcellation of occult uterine sarcomas during hysterectomy and myomectomy : Literature review and the ISGE recommendations. / Sizzi, Ornella; Manganaro, Lucia; Rossetti, Alfonso; Saldari, Matteo; Florio, Giuseppe; Loddo, Alessandro; Zurawin, Robert; van Herendael, Bruno; Djokovic, Dusan.
In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 220, 01.2018, p. 30-38.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Assessing the risk of laparoscopic morcellation of occult uterine sarcomas during hysterectomy and myomectomy
T2 - Literature review and the ISGE recommendations
AU - Sizzi, Ornella
AU - Manganaro, Lucia
AU - Rossetti, Alfonso
AU - Saldari, Matteo
AU - Florio, Giuseppe
AU - Loddo, Alessandro
AU - Zurawin, Robert
AU - van Herendael, Bruno
AU - Djokovic, Dusan
PY - 2018/1
Y1 - 2018/1
N2 - Objective This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. Study design The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment. A literature search within the Medline/PubMed and Cochrane Database was carried out using keywords “morcellation”, “uterine fibroids”, “uterine sarcoma”, “myomectomy” and “hysterectomy”. Relevant publications (original studies, meta-analyses and previous reviews), written in English and published until May 30th, 2017, were selected and analyzed. Previously emitted statements of 12 recognized professional societies or government institutions and their supporting literature were also studied. For each topic/clinical question, the available information was graded by the level of evidence. The ISGE recommendations were established in accordance with the evidence quality. Results In the light of available information, 9 recommendations on preoperative clinical, laboratorial and imaging evaluation of the candidates for intracorporeal uterus/leiomyoma morcellation were formulated, mainly based on consensus and expert opinions. There is a lack of high-quality evidence, which does not allow the establishment of strong recommendations. Conclusion Electromechanical tissue morcellation may be used in gynecological patients who are considered “low risk” upon appropriate preoperative evaluation; however, further studies and prospective data collection are greatly needed to improve sarcoma risk assessment in women with presumed uterine leiomyomas.
AB - Objective This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. Study design The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment. A literature search within the Medline/PubMed and Cochrane Database was carried out using keywords “morcellation”, “uterine fibroids”, “uterine sarcoma”, “myomectomy” and “hysterectomy”. Relevant publications (original studies, meta-analyses and previous reviews), written in English and published until May 30th, 2017, were selected and analyzed. Previously emitted statements of 12 recognized professional societies or government institutions and their supporting literature were also studied. For each topic/clinical question, the available information was graded by the level of evidence. The ISGE recommendations were established in accordance with the evidence quality. Results In the light of available information, 9 recommendations on preoperative clinical, laboratorial and imaging evaluation of the candidates for intracorporeal uterus/leiomyoma morcellation were formulated, mainly based on consensus and expert opinions. There is a lack of high-quality evidence, which does not allow the establishment of strong recommendations. Conclusion Electromechanical tissue morcellation may be used in gynecological patients who are considered “low risk” upon appropriate preoperative evaluation; however, further studies and prospective data collection are greatly needed to improve sarcoma risk assessment in women with presumed uterine leiomyomas.
KW - Power morcellation
KW - Preoperative assessment
KW - Uterine leiomyoma
KW - Uterine leiomyosarcoma
UR - http://www.scopus.com/inward/record.url?scp=85034015468&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2017.10.030
DO - 10.1016/j.ejogrb.2017.10.030
M3 - Review article
VL - 220
SP - 30
EP - 38
JO - European journal of obstetrics, gynecology, and reproductive biology
JF - European journal of obstetrics, gynecology, and reproductive biology
SN - 0301-2115
ER -