According to a new study, to remove the uterus with the least invasive procedure called morcellation is said to carry a risk of spreading more types of cancer.
A surgical tool that is used commonly in hysterectomies could potentially spread undetected cancer in a woman's body. The study reinforces a previous assessment of the government that said the use of laparoscopic power morcellator carries some risks.
"With this procedure, you are breaking up the uterus," gynecologic oncology chief from Columbia University of Physicians and Surgeons in NYC and lead author Dr. Jason Wright said. "You are essentially cutting through a cancer [if it is present] and that could theoretically spread the cancer to outside the uterus," he explained.
The research analyzed an insurance database including 15 percent of the nation's hospitalizations between 2006 and 2012. The team found 232,882 cases where women at 500 hospitals went through minimally invasive hysterectomies with the use of different approaches, including 36,470 women who underwent power morcellation.
Of the subjects, 99 women were diagnosed with uterine cancer detected afterward. If cancer had been detected prior to the procedure, morcellation would not have been done. This means one in 368 women who undergo hysterectomy had cancer that could be spread through morcellation.
Power morcellation has been a topic of debate since the FDA discouraged it in April. The agency said one in 350 women who undergo surgery to remove fibroids or hysterectomy had uterine cancer that doctors had not detected.
The researchers also found that 27 in 10,000 women who had morcellation done had undetected uterine cancer at the time they had the procedure done. The odds were highest for women 65 years old or more.
Surgeons use power cutters to slice the uterine tissue and remove these smaller fragments from small incisions through a laparoscope or tube in the abdomen. Some say morcellation helps doctors perform the least invasive procedure that's too important to forbid. Some experts say without morcellators, women would need to undergo abdominal hysterectomies which need longer recoveries and result in more complications and bigger scars. However, opponents say that there are alternatives including the mini-laparotomy and vaginal hysterectomies in which the tissue is removed from a small incision on top of the pubic bone.
