Hysteroscopic Morcellation Versus Resection for the Treatment of Uterine Cavitary Lesions: A Systematic Review and Meta-analysis

Sherif A M Shazly, Shannon K Laughlin-Tommaso, Daniel M. Breitkopf, Matthew R. Hopkins, Tatnai L. Burnett, Isabel C. Green, Ann M. Farrell, Mohammad H Murad, Abimbola O. Famuyide

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

This systematic review and meta-analysis compares hysteroscopic morcellation with electrosurgical resection to treat uterine cavitary lesions. A search of Ovid MEDLINE, Ovid Embase, Scopus, and Web of Science was conducted through August 18, 2015, for randomized controlled trials (RCTs) and prospective and retrospective studies, regardless of surgical indication and study language or sample size. Seven studies were eventually included (4 RCTs and 3 retrospective observational studies), enrolling 650 women. The meta-analysis showed that the total procedure time was significantly shorter for morcellation than for resection (weighted mean difference = 9.36 minutes; 95% confidence interval [CI], −15.08 to −3.64). When reviewing RCTs only, intrauterine morcellation was associated with a smaller fluid deficit and lower odds of incomplete lesion removal. This difference was not statistically significant in observational studies. There was no significant difference in the odds of surgical complications (odds ratio = 0.72; 95% CI, 0.20–2.57) or the number of insertions (weighted mean difference = −3.04; 95% CI, −7.86–1.78). In conclusion, compared with hysteroscopic resection, hysteroscopic morcellation is associated with a shorter operative time and possibly lower odds of incomplete lesion removal. The certainty in evidence was limited by heterogeneity and the small sample size.

Original languageEnglish (US)
Pages (from-to)867-877
Number of pages11
JournalJournal of Minimally Invasive Gynecology
Volume23
Issue number6
DOIs
StatePublished - Sep 1 2016

Keywords

  • Hysteroscopy
  • Polyps
  • Uterine bleeding
  • Uterine leiomyoma

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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