E. Alvarezrodas et al., HISTOLOGIC FEATURES OF THE CISH PROCEDURE, The Journal of the American Association of Gynecologic Laparoscopists, 2(1), 1994, pp. 37-41
Study Objective. To evaluate the classic intrafascial SEMM (serrated-e
dge macromorcellated) hysterectomy (CISH) performed by pelviscopy and
by laparotomy, and determine the histologic features of the procedures
. Design. The first 253 women who required hysterectomy were assigned
to undergo the procedure by pelviscopy or laparotomy based on uterine
size. Patients. One hundred fifty-two women underwent CISH by pelvisco
py and 101 by laparotomy. Interventions: Between September 1991 and De
cember 1993, the patients underwent the two procedures. Uterine leiomy
omas with menstrual disorders and pressure symptoms were the principal
indications (61%). Measurements and Main Results. Histologic findings
were in agreement with indications for the procedures. Leiomyomas and
leiomyomas with adenomyosis were the most frequent findings. Histolog
ic analysis revealed that the squamocolumnar transformation zone was t
otally removed in all cases, and all cervical glands were excised in 9
2%. Conclusion. Cervical dysplasia is not a contraindication to CISH,
but emphasizes the importance of adequate preoperative screening. This
is a conservative operation that may protect against some cervical ca
ncers.