Hystéroscopie diagnostique et risque de contamination péritonéale par les cellules tumorales

Yazbeck, Chadi; Dhainaut, C.; Batallan, A.; Bénifla, Jean-Louis; Thoury, A.; Madelenat, P.

doi:10.1016/j.gyobfe.2005.03.004

Cited by 22 publications

(2 citation statements)

References 25 publications

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“…However, in case of sarcoma the oncological effect of minimal amounts of spread or leakage, henceforth called micro-spillage, into the abdominal cavity is unclear. For instance, in endometrial carcinoma the spread of malignant cells in the abdominal cavity via the fallopian tubes during hysteroscopy does not appear to negatively influence clinical outcome [ 10 – 12 ]. The same might apply to our findings.…”

Section: Discussionmentioning

confidence: 99%

Towards spill-free in-bag morcellation: a health failure mode and effects analysis

et al. 2018

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BackgroundTo assess potential risks of new surgical procedures and devices before their introduction into daily practice, a prospective risk inventory (PRI) is a required step. This study assesses the applicability of the Health Failure Mode and Effects Analysis (HFMEA) as part of a PRI of new technology in minimally invasive gynecologic surgery.MethodsA reference case was defined of a patient with presumed benign leiomyoma undergoing a laparoscopic hysterectomy or myomectomy including in-bag power morcellation; however, pathology defined a stage I uterine leiomyosarcoma. Using in-bag morcellation as a template, a HFMEA was performed. All steps of the in-bag morcellation technique were identified. Next, the possible hazards of these steps were explored and possible measures to control these hazards were discussed.ResultsFive main steps of the morcellation process were identified. For retrieval bags without openings to accommodate instruments inside the bag, 120 risks were identified. Of these risks, 67 should be eliminated. For containment bags with openings 131 risks were identified of which 68 should be eliminated. Of the 10 causes most at risk to cause spillage, two can be eliminated by using appropriate bag materials. Myomectomy appears to be more at risk for residual tissue spillage compared to total hysterectomy.ConclusionThe HFMEA has provided important new insights regarding potential weaknesses of the in-bag morcellation technique, particularly with respect to hazardous steps in the morcellation process as well as requirements that bags should meet. As such, this study has shown HFMEA to be a valuable method that identifies and quantifies potential hazards of new technology.

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Section: Discussionmentioning

confidence: 99%

Towards spill-free in-bag morcellation: a health failure mode and effects analysis

et al. 2018

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“…However, in high risk populations for endometrial cancer, such as patients undergoing Tamoxifen theraphy, its recomended to use biopsy and hysteroscopic evaluation in combination ( 13 ) . Although its assumed that hysteroscopic examination in high risk patients for cancer, may increase the risk of dissemination of malignant cells into the peritoneal cavity, in recent meta-analyse no evidence was found to support an association between hysteroscopic examination and peritoneal cytology ( 14 ) .…”

Section: Discussionmentioning

confidence: 99%

Assessment of thickened endometrium in tamoxifen therapy

Korkmazer¹,

Solak²,

Tokgöz³

2014

tjod

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Objective:Aim of this study was to evaluate role of hysteroscopy in thickened endometrium (>5 mm) associated with tamoxifen therapy.Materials and Methods:We performed dilatation and curettage (D&C) and hysteroscopic biopsy to patients for evaluation of thickened endometrium in tamoxifen therapy. One hundred and nine asymptomatic patients with estrogen receptor positive breast cancer treated with tamoxifen 20 mg daily. We performed hysteroscopic biopsy or D&C to patients who have thickened endometrium at transvaginal sonography. We correlate pathology report results of D&C and hysteroscopic biopsy.Results:Fifty-nine of 103 patients have thickened endometrium.Thirty-five of 59 patients diagnosed with D&C (19 inactive endometrium, 15 endometrial polyp, 1 endometrial hyperplasia). D&C couldn’t get material 24 of these patients. Hysteroscopic biopsy diagnosed endometrial polyp 11 (45.8%) of these patients.Conclusion:We can state that D&C does not seem accurate enough for detection of intrauterin pathologies in thickened endometrium associated with tamoxifen therapy. We therefore believe it is reasonable to perform hysteroscopic biopsy in asymptomatic tamoxifen treated patients who have thickened endometrium.

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Intraperitoneal Drug Therapy: Physical and Biological Principles

Flessner

Peritoneal Carcinomatosis

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Hystéroscopie diagnostique et risque de contamination péritonéale par les cellules tumorales

Cited by 22 publications

References 25 publications

Towards spill-free in-bag morcellation: a health failure mode and effects analysis

Towards spill-free in-bag morcellation: a health failure mode and effects analysis

Assessment of thickened endometrium in tamoxifen therapy

Intraperitoneal Drug Therapy: Physical and Biological Principles

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