Related Experiment Video
Updated: Aug 12, 2025
Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
Published on: January 17, 2019
Subtotal hysterectomy reviewed: a stable or aperture for stump cervical malignancy. A referral hospital experience
Kamil Mosa Fram1, Shawqi Saleh1, Farah Fram1
1The University of Jordan, Jordan.
Insights
Subtotal hysterectomy (STH) may lead to stump malignancy, presenting with abnormal bleeding or Pap smears. Stump cancer often shows a worse stage, necessitating careful consideration of surgical approach and patient counseling.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
Background:
- Subtotal hysterectomy (STH) involves retaining the cervix, a practice with debated oncologic implications.
- Malignancy arising from the cervical stump after STH is a recognized but less common complication.
Purpose of the Study:
- To review the malignant potential of the cervical stump following subtotal abdominal hysterectomy.
- To analyze the clinical presentation, primary site, and management of stump malignancies.
Main Methods:
- Retrospective review of 33 patients diagnosed with stump malignancy between January 2018 and January 2022.
- Patients had previously undergone subtotal hysterectomy (STH) at outside institutions.
Main Results:
- Presenting symptoms included abnormal histopathology (24.24%), abnormal bleeding (21.21%), and postcoital bleeding/abnormal Pap smear (18.18%).
- The most common primary sites were endometrial (51.51%) and cervical (15.15%).
- Management involved surgery (54.54%), chemoradiation (27.27%), or palliative therapy (18.18%).
Conclusions:
- Stump cancer cases tend to present at a more advanced stage compared to cancers in intact uteruses.
- The potential for cervical stump problems warrants careful consideration before widespread adoption of STH.
- Further prospective studies are needed to clarify the risks and benefits of retaining the cervix during hysterectomy.
Introduction:
To review the malignant potential of the stump after subtotal abdominal hysterectomy. Material and methods: Thirty-three patients with stump malignancy were diagnosed and treated between January 2018 and January 2022. All patients primarily underwent subtotal hysterectomy (STH) outside our hospital due to different indications, most of which seemed non-convincing. Upon presentation, they were evaluated properly and offered the best management plan.
Results:
The presenting symptoms were abnormal histopathology report in 8 patients (24.24%), abnormal bleeding in 7 patients (21.21%), and postcoital bleeding and abnormal Pap smear in 6 patients (18.18%). The primary site of malignancy was endometrial in 17 patients (51.51%), on top of fibroid in 6 patients (18.18%), and cervical in 5 patients (15.15%). Eighteen patients (54.54%) underwent proper surgery, 9 patients (27.277%) were referred for chemoradiation, and 6 patients (18.18%) were candidates for palliative therapy.
Conclusions:
Stump cancer cases show a worse stage silhouette compared with cancer cases in intact uteruses. The high prevalence of cervical stump problems should be taken into account before a change in surgical approach from total to STH is deemed possible. Further prospective studies with prolonged follow-up periods are needed to evaluate the risks and benefits of retaining the cervix at hysterectomy. Subtotal hysterectomy is easier, does not require distinct skills that lead to experience and follow-up, and must be limited to the narrowest limits of practice, provided that the woman knows that there are no health benefits to keeping the cervix in place.
More Related Videos
03:32Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023