ABSTRACT
STUDY OBJECTIVE: To evaluate the incidence of leiomyosarcoma (LMS) at surgery for presumed uterine myomas according to different age groups. DESIGN: A retrospective cohort study. SETTING: A tertiary referral hospital. PATIENTS: All women undergoing surgery for presumed uterine myomas between January 1, 2006, and December 31, 2016. INTERVENTIONS: Laparoscopic myomectomy, laparotomic myomectomy, total hysterectomy, or hysteroscopic myomectomy. MEASUREMENTS AND MAIN RESULTS: A total of 1398 patients underwent surgery for presumed uterine myomas. The incidence of LMS was 2.15 per 1000 surgeries (nâ¯=â¯3, 1/466, 0.2%). In women under 40 years old, the incidence of occult LMS was 0 (0/561). In women between 40 and 49 years old, 190 myomectomies were performed (28% of the surgeries), and the rate of LMS was 1.49 per 1000 (nâ¯=â¯1, 1/673, 0.15%). In women over 49 years old, a total hysterectomy was performed in 82.3% of the cases, and the incidence of LMS was 12.2 per 1000 surgeries (nâ¯=â¯2, 1/82, 1.2%). CONCLUSION: The incidence of occult LMS in patients under 40 years old undergoing surgery for presumed uterine myomas was 0. These findings are suggestive that the use of power morcellation in this population may be safe.
Subject(s)
Laparoscopy , Leiomyoma , Leiomyosarcoma , Morcellation , Myoma , Uterine Myomectomy , Uterine Neoplasms , Adult , Female , Humans , Hysterectomy , Incidence , Leiomyoma/epidemiology , Leiomyoma/surgery , Leiomyosarcoma/epidemiology , Leiomyosarcoma/surgery , Middle Aged , Morcellation/adverse effects , Myoma/surgery , Retrospective Studies , Uterine Neoplasms/epidemiology , Uterine Neoplasms/surgeryABSTRACT
El motivo del presente estudio, es mostrar la utilidad de la metodología de Planificación Estratégica como una alternativa a la Planificación Tradicional y discutir las consideraciones teóricas de su aporte. La elaboración de la metodología de Planificación Estratégica, en apoyo a los Servicios de Salud o Programas, como el Materno Perinatal, ha implicado un cambio en la mentalidad de los distintos actores del sector con respecto a como enfrentar su problemática y adicional y paulatinamente se ha ido incorporando e internalizando como un medio útil en la elaboración de proyectos y programas específicos de salud. La planificación estratégica, ha representado en el Sector Público de Salud de Chile, un medio real y objetivo de fortalecer su capacidad institucional y colaborar en la modernización de la gestión de salud
