Practice patterns and postoperative complications before and after US Food and Drug Administration safety communication on power morcellation

Impact of the 2014 Food and Drug Administration Warnings Against Power Morcellation

“…In their study, 25% reported changing to an open approach for hysterectomy, and in our study, 46% reported an increased rate of laparotomy. In a retrospective cohort study by Harris et al [21] reviewing 18,299 hysterectomies, they found that utilization of laparoscopic hysterectomies decreased by 4.1%, whereas both abdominal and vaginal hysterectomies increased. They showed an increase in major surgical complications and hospital readmission, mirroring a concern from the open-ended responses in our study.…”

Is Laparoscopic Power Morcellation of Fibroids a Cardinal Sin in 2017?

“…By addressing risk factors for malignancy and incorporating evolving surgical techniques into practice, gynecologists can continue to offer patients a minimally invasive approach for fibroid management [4,8,23]. Studies published since the 2014 Food and Drug Administration safety communications offer updated leiomyosarcoma incidence estimates [8,23,24]. Incorporating these studies suggests that mortality rates are low following hysterectomy for presumed benign fibroids overall, and a minimally invasive approach remains a safe option [8,23,24].…”

“…Studies published since the 2014 Food and Drug Administration safety communications offer updated leiomyosarcoma incidence estimates [8,23,24]. Incorporating these studies suggests that mortality rates are low following hysterectomy for presumed benign fibroids overall, and a minimally invasive approach remains a safe option [8,23,24]. Risk associated with morcellation, however, increases in women age [50 years due to increased leiomyosarcoma rates, an important finding for patient-centered discussions of treatment options for fibroids [23].…”

Hysterectomy trends for benign indications over a 15-year period in an academic teaching center in Poland: a retrospective cohort study

“…The functional and anatomical outcome, quality of life and sexual function of patients who underwent hysterectomy for benign conditions has been published elsewhere [23,24]. We are aware of the fact that several factors can be associated with different choice of hysterectomy type, including geographic location, race and ethnicity, hospital grade, operating room equipment, and training pattern, while NHS reports show only the average nationwide trend in Poland [18,19]. This is the biggest cohort study evaluating the changing trends in operative gynecology conducted up-to-date in Poland.…”

“…The introduction of laparoscopy into gynecological surgical practice has changed hysterectomy trends dramatically [18]. The proportion of hysterectomies performed laparoscopically in the USA has increased significantly during the last 20 years, from 0.3% in 1990 to 11.8% in 2003 [19]. Recently, FDA issued a statement concerning the safety of power morcellation in case of LASH, especially in terms of oncological risks [20].…”