The Effect of Uterine Manipulator on Peritoneal Cytology Positivity in Endometrial Cancer: A Prospective Observational Study.

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2025-07-13 DOI:10.1002/dc.25497

Ceren Gerçek, Hande Nur Öncü, Tuğba Taşkın Türkmenoğlu, Candost Hanedan, Vakkas Korkmaz

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引用次数: 0

Abstract

Aim: There are studies suggesting that the use of a uterine manipulator during minimally invasive surgery (MIS) may lead to tumor spread in endometrial cancer patients, and there is no clear consensus on the safety of uterine manipulator use. The aim of this study was to investigate the effect of uterine manipulator use on peritoneal cytology (PC) results obtained before and after hysterectomy in endometrial cancer patients.

Methods: A single-center, prospective observational study was conducted, including 108 patients who were diagnosed with endometrial cancer and underwent surgical intervention. The patients were divided into three groups: Group 1 (n = 36), total abdominal hysterectomy (TAH); Group 2 (n = 41) laparoscopic hysterectomy with intrauterine manipulator (TLH with IUM); and Group 3 (n = 31) laparoscopic hysterectomy without IUM (TLH without IUM). PC samples were taken before and after the hysterectomy, and cytology results were compared among the groups.

Results: Of the 108 patients included in the study, 33.3% (36/108) were in Group 1, 38% (41/108) were in Group 2, and 28.7% (31/108) were in Group 3. The clinical and demographic data among the groups were similar (p > 0.05). PC was positive in six of the 108 patients. In the TLH with IUM group, one patient with a negative cytology sample before the manipulation showed a positive result after the hysterectomy.

Conclusions: Although statistical significance was not reached, utilizing an IUM to manage endometrial cancer with MIS may enhance cytology positivity. This finding requires further validation through larger prospective studies.

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子宫操纵器对子宫内膜癌腹膜细胞学阳性的影响：一项前瞻性观察研究。

目的：有研究提示子宫内膜癌患者在微创手术（MIS）中使用子宫操纵器可能导致肿瘤扩散，且对子宫操纵器使用的安全性尚无明确共识。本研究旨在探讨子宫操纵器的使用对子宫内膜癌患者子宫切除术前后腹膜细胞学（PC）结果的影响。方法：采用单中心前瞻性观察研究，纳入108例经诊断为子宫内膜癌并行手术干预的患者。患者分为三组：第一组（36例），全腹子宫切除术（TAH）；组2 （n = 41）采用宫内机械手（TLH with IUM）腹腔镜子宫切除术；第三组（n = 31）腹腔镜子宫切除术（TLH）。取子宫切除术前后PC标本，比较各组细胞学结果。结果：纳入研究的108例患者中，第1组占33.3%(36/108)，第2组占38%(41/108)，第3组占28.7%（31/108）。两组临床及人口学资料比较，差异无统计学意义（p < 0.05）。108例患者中有6例PC阳性。在TLH合并IUM组中，有1例患者在操作前细胞学样本为阴性，在子宫切除术后结果为阳性。结论：虽然没有达到统计学意义，但使用IUM治疗伴有MIS的子宫内膜癌可以提高细胞学阳性。这一发现需要通过更大规模的前瞻性研究进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.