The Food and Drug Administration released a safety communication in 2014 advising physicians not to do laparoscopic power morcellation for myomectomy, hysterectomies, or the removal of uterine fibroids. The purpose of this study was to ascertain how morcellation affected the survival rates (SRs) of patients with uterine sarcoma who had myomectomy or hysterectomy. The Web of Science, PubMed, Embase, and Scopus databases were searched for publications that had been published between the years 2003 and 2024. It aimed to find all original English-language studies comparing the outcomes between patients with uterine morcellation following laparoscopic myomectomy or hysterectomy and those without. A total of seven studies were included in this review. In most of the included studies, the group that underwent morcellation included patients undergoing laparoscopic, open abdominal, vaginal, and hysteroscopic surgery. In contrast, the group without morcellation consisted of all patients undergoing open abdominal surgery. Patients who had uterine morcellation were more likely to experience tumor metastases than those in the group without morcellation. The rate of reoperations was higher in patients who had morcellation than those who did not. Overall, five studies found that morcellation deteriorated outcomes, whereas the other two found no significant difference between morcellation and non-morcellation. The available evidence indicated that in patients with uterine sarcomas, morcellation increases the risk of intra-abdominal and total recurrences but not the risk of extra-abdominal recurrences. Nevertheless, a link was found between morcellation and reduced SRs.
Key words: morcellation, uterine sarcoma, myomectomy, laparoscopic, systemic review
|
