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Archives of Gynecology and Obstetrics

, Volume 287, Issue 3, pp 455–462 | Cite as

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

  • Juliane U. Theben
  • Alexander R. M. Schellong
  • Christopher Altgassen
  • Katharina Kelling
  • Stephanie Schneider
  • Dietmar Große-Drieling
General Gynecology

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.

Keywords

LASH Unexpected malignancies Leiomyosarcoma Endometrial cancer Laparoscopy Morcellation 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Juliane U. Theben
    • 1
  • Alexander R. M. Schellong
    • 2
  • Christopher Altgassen
    • 3
  • Katharina Kelling
    • 4
  • Stephanie Schneider
    • 5
  • Dietmar Große-Drieling
    • 1
  1. 1.Department of Gynecology and ObstetricsSt. Elisabeth Krankenhaus-HohenlindCologneGermany
  2. 2.CSC North American Public SectorFalls Church, VA University of MassachusettsAmherstUSA
  3. 3.Department of Gynecology and ObstetricsDRK Kliniken Berlin-WestendBerlinGermany
  4. 4.Department of Gynecology and ObstetricsUniversity of LuebeckLuebeckGermany
  5. 5.Department of Gynecology and Gynecologic OncologyKliniken Essen-MitteEssenGermany

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