Extent of Myometrial Resection With Various Surgical Methods for Endometrial Polypectomy Procedures.

Area of Science:

• Gynecologic Surgery
• Pathology
• Surgical Oncology

Background:

• Endometrial polypectomy is a common gynecologic procedure.
• Different surgical techniques exist, including hysteroscopic morcellation, hysteroscopic scissors, and dilation and curettage (D&C).
• The extent of myometrial resection during these procedures is not well-characterized.

Purpose of the Study:

• To compare the frequency and extent of myometrial resection across different surgical methods for endometrial polypectomy.
• To evaluate the prevalence of myometrium in pathology samples obtained via hysteroscopic morcellators, hysteroscopic scissors, and hysteroscopy with D&C.

Main Methods:

• A retrospective cohort study analyzed 458 pathology samples from patients aged 18-50.
• A blinded pathologist reevaluated samples for myometrium presence, percentage, isolated myometrium, and resection depth.
• Statistical analysis included Fisher exact and Kruskal-Wallis tests with Bonferroni correction.

Main Results:

• Hysteroscopic morcellation yielded significantly more myometrium (58.0%) compared to hysteroscopic scissors (9.8%) and D&C (15.3%).
• A greater percentage of samples from morcellation contained over 25% myometrium (26.0%) versus scissors (4.0%) and D&C (0.6%).
• Isolated myometrium was more prevalent with morcellation (11.0%) than D&C (0.7%).

Conclusions:

• Hysteroscopic morcellators result in significantly higher myometrial content in polypectomy samples.
• This suggests increased myometrial resection with morcellation compared to other methods.
• Further research may explore clinical implications of these findings.