Analysis of tumor metastasis caused by minimally invasive surgery of uterine neoplasm / 医学研究生学报

ABSTRACT

Objective Gynecologic minimally invasive surgery has become popular in the treatment of tumor therapy in re-cent years, but improper application can result in tumor metastasis.In this paper, we presented 6 uterine neoplasm cases of tumor me-tastasis after minimally invasive surgery and analyzed the causes and the preventive measures. Methods Retrospective analysis was made on the clinical data and pathology characteristics of the 6 uterine neoplasm cases of tumor metastasis after primary minimally inva-sive surgery in our department from January 1, 2013 to 2015 June 30, and related literature were reviewed. Results The ages of 6 patients were 39-52 years old.The primary operation methods included 2 cases of hysteroscopic myomectomy, 3 cases of laparoscopic myomectomy and 1 case of radiofrequency ablation.The pathological diagnosis after primary operations were 4 cases of uterine sarcoma ( low grade endometrial stromal sarcoma in 2 cases and leiomyosarcoma in 2 cases) who were found metastatic tumor at 3-16 months after primary surgery and finally died of the disease and 2 cases of uterine fibroids who were found metastatic tumor in abdominal cavity and puncture hole at 60 months and 108 months respectively after primary operation followed by a good prognosis after the second surgi-cal resection. Conclusion Owing to uterine neoplasm by hysteroscopy, laparoscopy often needs certain pressure and morcellation which may result in easy plantation of crushing tumor tis-sue or metastasis with circulation and puncture under pressure.Ra-diofrequency ablation lack of histopathologic diagnosis has heating effect which is inclined to speed up the spread and transfer of tumor cells once it is diagnosed as malignant.Therefore, clinicians should know the defects and risk of being lack of histopathologic diagno-sis, diagnostic curettage pathology and fast pathology to avoid tumor metastasis induced by minimally invasive surgery.