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Unexpected malignancies after laparoscopic-assisted supracervical hysterectomies (LASH): an analysis of 1,584 LASH cases

  • General Gynecology
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Abstract

Objective

The objective of this research was to identify the rate of unexpected malignancies after laparoscopic-assisted supracervical hysterectomies (LASH) and describe the therapy regime.

Methods

The research is based on a retrospective chart analysis of patients undergoing a simple hysterectomy in the gynecological endoscopy department of a general hospital in Germany.

Results

2,577 simple hysterectomies conducted between March 2005 and March 2010 were sub-classified in different types of hysterectomies (vaginal-, abdominal-, total-, abdominal supracervical hysterectomy, LAVH, and LASH). This study focuses on the LASH sub-group of 1,584 patients and does not make any comparisons to other operative approaches. Out of the 1,584 patients, 87.8 % (n = 1,391) received preoperative screening to exclude dysplasia or malignancy based on the policy of the German Association for gynecology and obstetrics (DGGG). The screening includes cytology (Pap-smear) and preoperative ultrasound of the uterus or dilatation and curettage (d&c). Unexpected malignancies were found in 0.25 % (n = 4) of the patients pre-screened according to DGGG protocol. Out of the four malign patients, two had endometrial cancer. Two patients had leiomyosarcoma.

Conclusion

The study shows that there is a small probability of unexpected malignancies even in correctly pre-screened patients for LASH procedures. Yet in the short-term (28–52 months), malign patients remain recurrence free after treatment. LASH is therefore a good procedure for assumed benign disease.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, St. Elisabeth Krankenhaus-Hohenlind, Werthmannstr. 1, 50935, Cologne, Germany

    Juliane U. Theben & Dietmar Große-Drieling

  2. CSC North American Public Sector, Falls Church, VA University of Massachusetts, Amherst, MA, USA

    Alexander R. M. Schellong

  3. Department of Gynecology and Obstetrics, DRK Kliniken Berlin-Westend, Berlin, Germany

    Christopher Altgassen

  4. Department of Gynecology and Obstetrics, University of Luebeck, Luebeck, Germany

    Katharina Kelling

  5. Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany

    Stephanie Schneider

Authors
  1. Juliane U. Theben
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  2. Alexander R. M. Schellong
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  4. Katharina Kelling
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Correspondence to Juliane U. Theben.

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Theben, J.U., Schellong, A.R.M., Altgassen, C. et al. Unexpected malignancies after laparoscopic-assisted supracervical hysterectomies (LASH): an analysis of 1,584 LASH cases. Arch Gynecol Obstet 287, 455–462 (2013). https://doi.org/10.1007/s00404-012-2559-0

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  • DOI: https://doi.org/10.1007/s00404-012-2559-0

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