Is laparoscopic extirpation of the cervical stump after laparoscopic supracervical hysterectomy justified in women with incidentally found atypical endometrial hyperplasia?

OBJECTIVE

An incidental finding of atypical endometrial hyperplasia (AEH) in women who have undergone laparoscopic supracervical hysterectomy (LASH) is a rare phenomenon, and it is unclear whether laparoscopic extirpation of the cervical stump (LECS) is justified in these patients.

METHODS

LECS due to AEH found incidentally in the morcellated uterus after LASH.

RESULTS

A total of 332 women underwent LASH between January 2002 and September 2010. Five of the women (1.5%) underwent secondary LECS procedures due to histological evidence of AEH or focal atypical endometrial cells found incidentally in the morcellated uterus. No atypical endometrial cells were histologically diagnosed in the cervical stump in any of the cases, nor were any endometrial cells found in the cervical stumps in any of the 5 patients. There was no abdominal evidence at all of any disseminated endometrial cells. In all 5 cases, cytological examination of peritoneal fluid confirmed the absence of adenocarcinoma cells.

CONCLUSIONS

No signs of AEH were found in the removed cervical stumps. However, women should receive counseling regarding the need for secondary LECS to minimize any risks in such cases.