Utility of preoperative endometrial assessment in asymptomatic women undergoing hysterectomy for pelvic floor dysfunction
Utility of preoperative endometrial assessment in asymptomatic women undergoing hysterectomy for pelvic floor dysfunction
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DOI：
10.1007/s00192-012-1694-2
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发表时间：
2012-07-01
影响因子：
1.8
通讯作者：
Kenton, Kimberly S.
中科院分区：
文献类型：
--
作者：
Ramm, Olga;Gleason, Jonathan L.;Kenton, Kimberly S.
在腹腔镜手术中进行子宫分碎术进行骨盆底修补，促使一些外科医生采用子宫筛查试验。我们报告了一个在骨盆底手术时偶然诊断为子宫恶性肿瘤的病例系列。我们回顾了2004年1月至2009年12月因盆腔器官脱垂（POP）和/或尿失禁（UI）而接受子宫切除术的患者的记录，并提取了术前筛查趋势和最终病理诊断。在研究的708名妇女中，125例（18%）术前进行了子宫内膜活检（EB），43例（6%）进行了盆腔超声（US），21例（3%）进行了EB和US。手术途径包括阴道（58%）、腹部（23%）和腹腔镜（18%）。大多数（97.1%）最终病理诊断为良性。检测到5例癌症（0.6%）;其中4例术前筛查正常，包括EB（2）、US（1）或两种检查（1）。由于计划POP/UI手术的无症状女性中未检测到子宫癌的患病率较低，因此EB + US筛查在我们的患者队列中无效。
Uterine morcellation during laparoscopy for pelvic floor repair has prompted adoption of uterine screening tests by some surgeons. We report a case series of uterine malignancy incidentally diagnosed at the time of pelvic floor surgery.We reviewed records from patients undergoing hysterectomy for pelvic organ prolapse (POP) and/or urinary incontinence (UI) from January 2004 to December 2009 and abstracted preoperative screening trends and final pathologic diagnoses.Of the 708 women in the study, 125 (18%) had preoperative endometrial biopsy (EB), 43 (6%) had pelvic ultrasound (US), and 21 (3%) had EB and US. Surgical route included vaginal (58%), abdominal (23%), and laparoscopic (18%). Most (97.1%) final pathologic diagnoses were benign. Five cancers (0.6%) were detected; four of these women had normal preoperative screening, including EB (2), US (1), or both tests (1).Screening with EB + US was found to be ineffective in our cohort of patients due to the low prevalence of undetected uterine cancer in asymptomatic women planning POP/UI surgery.