Premature Judgment of Uterine Morcellation: Look at the Data Before You Leap
Menée à partir d'un modèle de simulation intégrant des données péri-opératoires, cette étude estime le bénéfice, en terme de survie, les risques et le coût d'une hystérectomie laparoscopique par morcellation électrique et d'une hystérectomie par voie laparoscopique ou abdominale chez les patientes présentant une maladie gynécologique apparemment bénigne
The benefits of laparoscopic (minimally invasive) surgery for gynecologic conditions requiring surgery are very clear and have been defined many times in the recent literature (1–3). The advantages include faster recovery, less blood loss, improved quality of life, and generally less morbidity. Hence, almost 50% of the inpatient hysterectomies done each year in the United States are done via laparoscopy (4). Additionally, many women benefit from other minimally invasive surgeries including diagnostic laparoscopies and myomectomies.
Given the widespread use and benefits of laparoscopy, technology has developed to make the process more efficient and solve some of its challenges. One notable challenge was cases in which the uterus is too large to be removed through the laparoscopic incision and would otherwise need to be removed via a large laparotomy incision (5,6). This problem was solved by development of morcellation, which breaks the tissue into smaller pieces and can either be done manually with a scalpel or electromechanically with a power morcellator.
Morcellation, for which the …
Journal of the National Cancer Institute , éditorial, 2015