Prevalence of Occult Malignancy Within Morcellated Specimens Removed During Laparoscopic Sacrocolpopexy. Issue 4 (July 2016)

• Record Type: Journal Article
• Authors: Vallabh-Patel, Vaneesha; Saiz, Cristina; Salamon, Charbel; Francis, Amanda; Pagnillo, Jennifer; Culligan, Patrick
• Is Part Of: Female pelvic medicine & reconstructive surgery. Volume 22:Issue 4(2016:Jul./Aug.)
• Publication Date: 2016-07
• Subjects: occult malignancy -- morcellation -- morcellated specimens -- laparoscopic sacrocolpopexy; Pelvis -- Diseases -- Periodicals; Pelvis -- Surgery -- Periodicals; Genital Diseases, Female -- surgery -- Periodicals; Urologic Diseases -- surgery -- Periodicals; Colonic Diseases -- surgery -- Periodicals; Rectal Diseases -- surgery -- Periodicals; Surgical Procedures, Operative -- methods -- Periodicals; 616.6
• DOI: 10.1097/SPV.0000000000000257
• Languages: English
• ISSNs: 2151-8378

Abstract

Abstract : Objective: This study aimed to determine the prevalence of occult malignancy found in morcellated specimens removed in the context of pelvic organ prolapse repair operations. Methods: A total of 786 cases were reviewed from a single health system between October 2006 and July 2015. Thorough chart reviews were performed to include pathological specimens. Demographic, perioperative, and postoperative data were collected. Results: Four occult malignancies were identified including 3 endometrial adenocarcinomas of the uterus and 1 papillary serous carcinoma of the uterus. The overall prevalence of occult malignancy within morcellated specimens was 0.5% (4 of 786). On adopting universal screening with endometrial biopsy, 5 malignancies were identified (5 of 176) before morcellation and no postoperative malignancies in the remaining patients. Conclusions: Power morcellation is a low-risk procedure with laparoscopic supracervical hysterectomy and sacrocolpopexy. Universal screening is highly effective in detecting occult malignancy and in our small series eliminated the risk; studies in multiple institutions will be needed to determine its effectiveness in other hospital systems. Abstract : This is a retrospective study assessing the prevalence of occult malignancy in morcellated specimens during pelvic organ prolapse surgeries.