Three-dimensional classification of radical hysterectomy: new saddle for an old horse.

摘要

First, as the authors reminded, there are no specific clinical or paraclinical pre-operative signs to evoke LMS, especially in young perimenopausal women undergoing surgery for presumed leiomyoma. However, we do not share the authors' opinion concerning the notion of a "rapidly growing uterus" as a potential clue to uterine LMS. Indeed, the definition of a "rapidly growing uterus" is quite subjective and does not seem specific. In a series of patients operated for presumed leiomyoma, Parker et al. found no case of LMS in 371 patients presenting with a "rapidly growing leiomyoma" [5]. Furthermore, in a more recent study, we found only two cases of LMS among 155 patients presenting with a "rapidly growing uterus" at the time of hysterectomy [6]. Therefore, we deem that a history of "rapidly growing leiomyoma" alone in a perimenopausal woman should not be the sole criteria to avoid non laparotomic surgical routes.