Abstract: Objective：A case control study of unexpected uterine sarcomas between laparoscopy and laparotomy was done to determine the influence of morcellation on the disease and to explore the early diagnosis by analyzing their characteristics. Methods：Between November 2008 and November 2014, all of uterine sarcomas diagnosed after operation for benign uterine fibroid were abstracted and the patients were divided into two groups, laparoscopy (8 cases) or laparotomy (47 cases). Morcellator was used in laparoscopy, but not in laparotomy. The clinical datas were reviewed. Results：The number of unexpected uterine sarcomas is 55 cases, 16 cases (7 laparoscopies and 9 laparotomies) underwent second surgery. Compared with laparotomy, laparoscopy had a higher risk of second surgery (87.5% vs. 19.1%, P=0.000) and pelvic planting and metastasis (2 cases vs. 0 case), and a lower rate of pathologic diagnosis (37.5% vs. 76.6%, P=0.038). Conclusions：Laparoscopic morcellation had a higher risk of second surgery and pelvic planting and metastasis, and a lower rate of pathologic diagnosis. This should be paid more attention by clinicians and some measures should be taken to avoid the risk.

Key words: Sarcoma，endometrial stromal, Leiomyoma, Laparoscopes, Gynecologic surgical procedures, Uterine sarcoma, Morcellation