Distribucín de la patología quiŕrgica del cuerpo uterino en mujeres chilenas sometidas a histerectomía en un hospital clínico universitar

Abstract

Background: Hysterectomy is the most frequently performed gynecologic procedure worldwide. Few studies have been done to analysis the distribution of pathological findings in hysterectomies. Objectives: To determine the distribution of epithelial and non-epithelial pathology in patients undergoing hysterectomy for uterine disease in an academic centre. To establish what is the percentage and the etiology of concurrent pathologies and the incidence of unexpected cancer within patients undergoing surgery for a presumably benign condition. Methods: A retrospective study was done of all the patients undergoing hysterectomy between 1991 and 2005. In addition a descriptive analysis of the distribution of benign and malignant conditions originated in the uterine corpus was done highlighting the occurrence of incidental cancer among different preoperative diagnosis. Results: During the period, 5683 hysterectomies were performed. In 4275 cases a non-epithelial pathology was found, mainly, fibroids and adenomyosis. In 2070 cases endometrial pathology was diagnosed: atrophy, polyps and hyperplasia as the most prevalent findings. In 905 cases myometrial and endometrial pathology of uterine corpus coexists. In 240 cases any pathology was found (4.2%). In 1% of hysterectomies an incidental gynecological cancer was found, and the two conditions more frequently associated were metrorrhagia and polyps. Conclusions: The distribution of etiologies for the uterine pathology, is similar to other international series. The most common finding is fibroid frequently associated to adenomyosis. It is important to highlight the incidental finding of endometrial cancer among patients operated on by metrorrhagia and/or polyps. Based on this, we recommend the routine use of preoperative biopsy in patients with metrorrhagia and frozen section biopsy in those with polyps.