ArticleAmerican journal of obstetrics and gynecology2015
Laparoscopic hysterectomy with morcellation vs abdominal hysterectomy for presumed fibroid tumors in premenopausal women: a decision analysis.
Article in American journal of obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 104 citations in OpenAlex.
- Two-dimensional (2D) versus three-dimensional (3D) laparoscopy for vaginal cuff closure by surgeons-in-training: a randomized controlled trial.Surgical endoscopy · 2020Trial
- A case of giant thymolipoma: case report.AME case reports · 2026Article
- Review
- A new knotless parametrial tissue ligation technique for safe total laparoscopic hysterectomy.Obstetrics & gynecology science · 2024Article
- Rate of Leiomyosarcomas during Surgery for Uterine Fibroids: 8-Year Experience of a Single Center.Journal of clinical medicine · 2023Article
- Contained Power Morcellation in Laparoscopic Uterine Myoma Surgeries: A Brief Review.Healthcare (Basel, Switzerland) · 2023Review
- Epigenomic and enhancer dysregulation in uterine leiomyomas.Human reproduction update · 2022Review
- Safety Warning about Laparoscopic Power Morcellation in Hysterectomy: A Cost-Effectiveness Analysis of National Impact.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Preclinical safety testing and initial experience of a morcellation bag with four sealable ports.Scientific reports · 2021Article
- [Interdisciplinary S2k guidelines on the diagnosis and treatment of uterine sarcomas-recommendations for surgical pathology].Der Pathologe · 2020Review
- Laparoscopic hysterectomy as optimal approach for 5400 grams uterus with associated polycythemia: A case report.World journal of clinical cases · 2019Article
- Practice Patterns and Complications of Benign Hysterectomy Following the FDA Statement Warning Against the Use of Power Morcellation.JAMA surgery · 2018Article
- Malignant transformation of uterine leiomyoma to myxoid leiomyosarcoma after morcellation associated withOncotarget · 2018Article
- Safety and feasibility of contained uterine morcellation in women undergoing laparoscopic hysterectomy.Gynecologic oncology research and practice · 2018Article
- Characterization and Preoperative Risk Analysis of Leiomyosarcomas at a High-Volume Tertiary Care Center.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2017Article
- Prevalence of occult pre-malignant or malignant pathology at the time of uterine morcellation for benign disease.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2017Article
- Laparoscopic hysterectomy with morcellation vs abdominal hysterectomy for presumed fibroids: an updated decision analysis following the 2014 Food and Drug Administration safety communications.American journal of obstetrics and gynecology · 2017Article
- Uterine fibroid management: from the present to the future.Human reproduction update · 2016Review
- Incidence of occult leiomyosarcoma in presumed morcellation cases: a database study.European journal of obstetrics, gynecology, and reproductive biology · 2016Article
- Cost-Effectiveness of Laparoscopic Hysterectomy With Morcellation Compared With Abdominal Hysterectomy for Presumed Myomas.Journal of minimally invasive gynecology · 2016Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe purpose of this study was to model outcomes in laparoscopic hysterectomy with morcellation compared with abdominal hysterectomy for the presumed fibroid uterus and to examine short- and long-term complications and death. STUDY
designA decision tree was constructed to compare outcomes for a hypothetical cohort of 100,000 premenopausal women who underwent hysterectomy for presumed fibroid tumors over a 5-year time horizon. Parameter and quality-of-life utility estimates were determined from published literature for postoperative complications, leiomyosarcoma incidence, death related to leiomyosarcoma, and procedure-related death.
resultsThe decision-tree analysis predicted fewer overall deaths with laparoscopic hysterectomy compared with abdominal hysterectomy (98 vs 103 per 100,000). Although there were more deaths from leiomyosarcoma after laparoscopic hysterectomy (86 vs 71 per 100,000), there were more hysterectomy-related deaths with abdominal hysterectomy (32 vs 12 per 100,000). The laparoscopic group had lower rates of transfusion (2400 vs 4700 per 100,000), wound infection (1500 vs 6300 per 100,000), venous thromboembolism (690 vs 840 per 100,000) and incisional hernia (710 vs 8800 per 100,000), but a higher rate of vaginal cuff dehiscence (640 vs 290 per 100,000). Laparoscopic hysterectomy resulted in more quality-adjusted life years (499,171 vs 490,711 over 5 years).
conclusionThe risk of leiomyosarcoma morcellation is balanced by procedure-related complications that are associated with laparotomy, including death. This analysis provides patients and surgeons with estimates of risk and benefit on which patient-centered decisions can be made.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.