UTERINE MORCELLATION IN MINIMALLY INVASIVE SURGERY, SHOULD BE APPLIED ? OR SHOULD NOT BE APPLIED ?

Year 2016, Volume: 19 Issue: 3, 93 - 98, 21.05.2018

Yusuf Aytaç Tohma , Eda Kocaman Mehmet Tunç Hüseyin Akıllı Hulusi Bülent Zeyneloğlu Ali Ayhan

Abstract

In recent years, minimally invasive surgery has been preferred to open abdominal procedures in gynecology. The one of the biggest
problem in minimally invasive surgery is extraction of large uteri or myomas. For this purpose, morcellators are used for removal of tissues
which are divided into small pieces with electromechanical or manuel power. Since the safety warning from the US Food and Drug Administration
about the use of power morcellators, minimally invasive procedures involving the removal of large uterus and myomas are under
review. Scientific proofs about that morcellation of undiagnosed uterine sarcomas is associated with worse survival outcomes of pa-tients
are increasing. However currently a few data about morcellation of occult uterine malignan-cies are available. We will discuss the effects
of morcellation of undiagnosed uterine malignancies, focusing on possible radiologic imaging techniques for preoperative diagnosis of
uterine sarcoma and for avoiding intra-abdominal dissemination of potentially malignant tissues in this review. However, according to
current data, intra-abdominal morcellation should be banned from clinical practice.

Keywords

Uterine sarcoma, power morcellation, minimal invasive surgery

MİNİMAL İNVAZİV CERRAHİDE UTERİN MORSELASYON, UYGULANMALI MI ? UYGULANMAMALI MI ?

Abstract

Son yıllarda jinekolojide minimal invaziv cerrahi, açık abdominal cerrahilere tercih edilmektedir. Minimal invaziv cerrahideki en büyük
problemlerden biri büyük uterusların ve leiomyomların batın dışına çıkarılmasıdır. Bu amaçla morselatör olarak adlandırılan ve dokuların
elektromekanik güç ile ya da manuel olarak küçük parçalara bölünerek batın dışına çıkarılmasını sağlayan cerrahi aletler kullanılmaktadır.
The US Food and Drug Administration (FDA)’nın power morselatör kul-lanımı ile ilgili güvenlik uyarısı sonrasında, minimal invaziv cerrahide
büyük uterus ve myomların çıkarılması ile ilgili derlemeler artmıştır. Tanı konulmamış uterin sarkomların morselasyonu neden-li,
hastaların kötü sağkalım sonuçlarını gösteren bilimsel kanıtlar artmaktadır. Fakat şu anda okült uterus maligniteleri ile ilgili az sayıda veri
bulunmaktadır. Biz bu derlemede, morselasyonun tanı konulmamış uterus malignitelerinin üzerindeki etkisini, uterin sarkomların preoperatif
tanısı için kullanılabilecek radyolojik görüntüleme tekniklerini ve potansiyel malign dokuların intraabdomi-nal yayılımının nasıl önüne
geçilebileceğini tartıştık fakat şu anki veriler ışığında klinik pratikte intraabdominal morselasyondan kaçınılmalıdır

Keywords

Uterin sarkom, power morselasyon, minimal invaziv cerrahi

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