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


CONCLUSIONS
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.
Department of Gynecology and Obstetrics, St. Elisabeth Krankenhaus-Hohenlind, Werthmannstr. 1, 50935 Cologne, Germany. juliane.theben@hohenlind.de
Juliane U
JU
Theben
Alexander R M
AR
Schellong
Christopher
C
Altgassen
Katharina
K
Kelling
Stephanie
S
Schneider
Dietmar
D
Große-Drieling
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology*; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D033162:Incidental Findings; D010535:Laparoscopy; D007890:Leiomyosarcoma / Q000453:epidemiology*; D008875:Middle Aged; D009366:Neoplasm Seeding; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000453:epidemiology*