Laparoscopic myomectomy and morcellation: A review of techniques, outcomes, and practice guidelines

被引:39
作者
Glaser, Laura M. [1 ]
Friedman, Jaclyn [1 ]
Tsai, Susan [1 ]
Chaudhari, Angela [1 ]
Milad, Magdy [1 ]
机构
[1] Northwestern Univ, Feinberg Sch Med, Div Minimally Invas Gynecol, 250 E Super,Suite 03-2303, Chicago, IL 60611 USA
关键词
Laparoscopic myomectomy; Power morcellation; Leiomyosarcoma; CONTAINED POWER MORCELLATION; UTERINE ARTERY EMBOLIZATION; SUPRACERVICAL HYSTERECTOMY; ABDOMINAL MYOMECTOMY; SURVIVAL OUTCOMES; LEARNING-CURVE; LEIOMYOMAS; FIBROIDS; SURGERY; IMPACT;
D O I
10.1016/j.bpobgyn.2017.09.012
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Laparoscopic myomectomy is a minimally invasive surgical approach to treat symptomatic uterine fibroids in women wishing for a uterine-sparing procedure. With careful patient selection, these procedures are associated with favorable reproductive outcomes and low perioperative morbidity. Current available methods for specimen retrieval include power and hand morcellation. The 2014 FDA safety warnings regarding power morcellation arose from concerns about the spread of occult malignancy and prompted widespread use of containment systems that may limit spread of myometrial cells. Investigation into the clinical effects of laparoscopic myomectomy and uncontained morcellation on the prognosis and spread of occult leiomyosarcoma has yielded mixed results. Other complications of uncontained power morcellation exist, including the development of parasitic leiomyomas. The FDA safety warnings have greatly influenced trends in benign gynecologic surgery, and survey data reflect trends in providers' opinions of these trends. In conclusion, recommendations for the current practice of laparoscopic myomectomy and morcellation are reviewed. (C) 2017 Published by Elsevier Ltd.
引用
收藏
页码:99 / 112
页数:14
相关论文
共 93 条
  • [11] Surveillance, Epidemiology, and End Results analysis of 2677 cases of uterine sarcoma 1989-1999
    Brooks, BE
    Zhan, M
    Cote, T
    Baquet, CR
    [J]. GYNECOLOGIC ONCOLOGY, 2004, 93 (01) : 204 - 208
  • [12] The impact of aptitude on the learning curve for laparoscopic suturing
    Buckley, Christina E.
    Kavanagh, Dara O.
    Nugent, Emmeline
    Ryan, Donncha
    Traynor, Oscar J.
    [J]. AMERICAN JOURNAL OF SURGERY, 2014, 207 (02) : 263 - 270
  • [13] Adhesion formation after laparoscopic myomectomy
    Bulletti, C
    Polli, V
    Negrini, V
    Giacomucci, E
    Flamigni, C
    [J]. JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS, 1996, 3 (04): : 533 - 536
  • [14] Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids
    Butori, Noemie
    Tixier, Herve
    Filipuzzi, Laurence
    Mutamba, William
    Guiu, Boris
    Cercueil, Jean-Pierre
    Douvier, Serge
    Sagot, Paul
    Krause, Denis
    Loffroy, Romaric
    [J]. EUROPEAN JOURNAL OF RADIOLOGY, 2011, 79 (01) : 1 - 6
  • [15] Reproductive outcome before and after laparoscopic or abdominal myomectomy for subserous or intramural myomas
    Campo, S
    Campo, V
    Gambadauro, P
    [J]. EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2003, 110 (02) : 215 - 219
  • [16] Gonadotropin-Releasing Hormone Agonist in Laparoscopic Myomectomy: Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Chen, Innie
    Motan, Tarek
    Kiddoo, Darcie
    [J]. JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2011, 18 (03) : 303 - 309
  • [17] Minimally invasive surgical techniques versus open myomectomy for uterine fibroids
    Chittawar, Priya Bhave
    Franik, Sebastian
    Pouwer, Annefloor W.
    Farquhar, Cindy
    [J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2014, (10):
  • [18] Laparoscopy vs Minilaparotomy in Women with Symptomatic Uterine Myomas: A Prospective Randomized Study
    Cicinelli, Ettore
    Tinelli, Raffaele
    Colafiglio, Giuseppe
    Sallani, Nicola
    [J]. JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2009, 16 (04) : 422 - 426
  • [19] Contained tissue extraction using power morcellation: prospective evaluation of leakage parameters
    Cohen, Sarah L.
    Morris, Stephanie N.
    Brown, Doug N.
    Greenberg, James A.
    Walsh, Brian W.
    Gargiulo, Antonio R.
    Isaacson, Keith B.
    Wright, Kelly N.
    Srouji, Serene S.
    Anchan, Raymond M.
    Vogell, Alison B.
    Einarsson, Jon I.
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2016, 214 (02) : 257.e1 - 257.e6
  • [20] THE FREQUENCY OF UTERINE LEIOMYOMAS
    CRAMER, SF
    PATEL, A
    [J]. AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 1990, 94 (04) : 435 - 438