ArticleObstetrics and gynecology2019
Hysterectomy Practice Patterns in the Postmorcellation Era.
Article in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Applying social vulnerability index to examine social disparities in patients undergoing hysterectomy.AJOG global reports · 2025Article
- Endometrial cancer decades after supracervical hysterectomy for placenta accreta spectrum: A case report.Gynecologic oncology reports · 2025Article
- Systematic review and meta-analysis of vaginal natural orifice transluminal endoscopic surgery vs laparoscopic hysterectomy.AJOG global reports · 2024Review
- Standardized 10-step approach for successfully performing a hysterectomy via vaginal natural orifice transluminal endoscopic surgery.Acta obstetricia et gynecologica Scandinavica · 2022Review
- Higher prevalence of hysterectomy among rural women than urban women: Implications for measures of disparities in uterine and cervical cancers.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- US hysterectomy prevalence by age, race and ethnicity from BRFSS and NHIS: implications for analyses of cervical and uterine cancer rates.Cancer causes & control : CCC · 2022Article
- Safety Warning about Laparoscopic Power Morcellation in Hysterectomy: A Cost-Effectiveness Analysis of National Impact.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Retrospective analysis of secondary resection of the cervical stump after subtotal hysterectomy: why and when?Archives of gynecology and obstetrics · 2021Article
- Hospital variation in responses to safety warnings about power morcellation in hysterectomy.American journal of obstetrics and gynecology · 2021Article
- The effects of laparoscopic myomectomy and open surgery on uterine myoma patients' postoperative immuno-inflammatory responses, endocrine statuses, and prognoses: a comparative study.American journal of translational research · 2021Article
- Preoperative MRI and LDH in women undergoing intra-abdominal surgery for fibroids: Effect on surgical route.PloS one · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal.
methodsThis was a descriptive study using data from the American College of Surgeons National Surgical Quality Improvement Program from 2012 to 2016. We identified hysterectomies using Current Procedural Terminology codes. We used an interrupted time-series analysis to evaluate abdominal and supracervical hysterectomy trends surrounding The Wall Street Journal article first reporting morcellation safety concerns and the FDA safety communication. We compared categorical and continuous variables using χ, t, and Wilcoxon rank sum tests.
resultsWe identified 179,950 hysterectomies; laparoscopy was the most common mode of hysterectomy in every quarter. Before The Wall Street Journal article, there was no significant change in proportion of abdominal hysterectomies (0.3% decrease/quarter, P=.14). After The Wall Street Journal article, use of abdominal hysterectomy increased 1.1% per quarter for two quarters through the FDA warning (P<.001), plateaued for three quarters until March 2015 (P=.65), then decreased by 0.8% per quarter through 2016 (P<.001). Supracervical hysterectomy volume continuously decreased after the FDA warning (1.0% decrease per quarter, P<.001) and after three quarters (0.7% decrease per quarter, P=.01), then plateaued from April 2015 through 2016 (0.05% decrease per quarter, P=.40). Mode of supracervical hysterectomy was unchanged from 2012 to 2013 (P=.43), followed by two quarters of significant increase in proportion of supracervical abdominal hysterectomies (11.7%/quarter, P<.001). This change in mode of supracervical hysterectomy then plateaued through 2016 (P=.06).
conclusionDespite early studies suggesting that minimally invasive hysterectomy decreased in response to safety concerns regarding power morcellation, we found that this effect reversed 1 year after the FDA safety communication. However, there was a sustained decline in supracervical hysterectomy, and the remaining supracervical hysterectomies were more likely to be performed using laparotomy.
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