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Risk of unexpected uterine leiomyosarcoma during laparoscopic procedures: Experience from a single tertiary institute in Italy

OBJECTIVE: To evaluate the incidence of occult uterine sarcomas and investigate whether an accurate and well‐established preoperative assessment for uterine fibroids could help identify uterine sarcomas more effectively. METHODS: A retrospective analysis of patients who underwent gynecological lapar...

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Detalles Bibliográficos
Autores principales: Surace, Alessandra, Baù, Maria Grazia, Privitera, Sebastiana, Botta, Giovanni, Danese, Saverio, Plazzotta, Claudio, Mitidieri, Marco, Picardo, Elisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291939/
https://www.ncbi.nlm.nih.gov/pubmed/33834486
http://dx.doi.org/10.1002/ijgo.13701
Descripción
Sumario:OBJECTIVE: To evaluate the incidence of occult uterine sarcomas and investigate whether an accurate and well‐established preoperative assessment for uterine fibroids could help identify uterine sarcomas more effectively. METHODS: A retrospective analysis of patients who underwent gynecological laparoscopic surgery for presumed uterine fibroids at Sant’Anna Hospital, a single tertiary institute in Turin, Italy, between January 2003 and December 2019. RESULTS: Over the 17‐year period, 5826 laparoscopic surgical procedures (myomectomies or subtotal/total hysterectomies) were performed for presumed uterine fibroids. A total of 48 patients with a final diagnosis of uterine sarcoma were identified, the majority of which (n = 39; 81.3%) were recognized as suspicious uterine sarcomas during the preoperative assessment, and morcellement was avoided. The occurrence of unexpected uterine sarcomas was 0.1% (6/5826). Morcellation was conducted in one patient with uterine sarcoma. CONCLUSION: Analysis of our data showed that unexpected uterine sarcomas are uncommon. Accurate preoperative evaluation can help avoid, but does not exclude, the possibility of morcellation of unknown uterine sarcomas.