Orozco Leonardo J, Salazar Arturo, Clarke Jane, Tristan Mario
OBGYN Women's Hospital San José, Costa Rica., Caja Costarricense Seguro Social (CCSS)., Bo california, San José, San Pedro Montes de Oca, Costa Rica, 1677-2100.
Cochrane Database Syst Rev. 2008 Jul 16(3):CD005638. doi: 10.1002/14651858.CD005638.pub2.
Prophylactic oophorectomy alongside hysterectomy in premenopausal women is common. The decision to remove or conserve the ovaries is often based on the perceived risk for ovarian cancer and the need for other additional gynaecological surgical interventions. The benefits or harms of prophylactic bilateral oophorectomy at the time of hysterectomy in premenopausal women are unknown.
To determine whether premenopausal women with hysterectomy without oophorectomy for benign gynaecological conditions versus hysterectomy plus bilateral oophorectomy would have a higher mortality rate and future gynaecological surgical interventions.
We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (December 2005 to October 2007) and the following electronic databases: CENTRAL (The Cochrane Library 2007, Issue 4), MEDLINE (January 1966 to October 2007), EMBASE (January 1985 to October 2007), LILACS (January 1982 to October 2007), Biological Abstracts (January 1968 to October 2007), NHS Economic Evaluation Database (inception to October 2007), Health Technology Assessment Database (inception to October 2007), and the Meta RCTs (inception to October 2007). Reference lists of relevant articles were also searched.
Randomised controlled and controlled trials of hysterectomy (using any surgical approach) without oophorectomy versus hysterectomy (using any surgical approach) with bilateral oophorectomy in premenopausal women with benign gynaecological conditions.
Three review authors independently assessed trials for inclusion, determined study quality and extracted data. Study authors were contacted where information was unclear.
Of the 119 studies identified, only one controlled trial was included. Therefore, a quantitative meta-analysis was not feasible. The results of this study (with two publications) including 362 women were summarised in a narrative format. No randomised controlled trials were found. Neither publication reported on the primary outcomes stated in this review. The trial showed evidence of very low quality of a positive effect on psychological well-being for both groups at one year follow up. No significant differences were found between the groups of women studied regarding any aspect of their sexuality.
AUTHORS' CONCLUSIONS: The conclusions of this review are limited by the lack of data. More research of higher methodological quality is needed.
绝经前女性在子宫切除术中同时进行预防性卵巢切除术很常见。保留或切除卵巢的决定通常基于对卵巢癌风险的认知以及其他额外妇科手术干预的需求。绝经前女性在子宫切除时进行预防性双侧卵巢切除术的益处或危害尚不清楚。
确定因良性妇科疾病行子宫切除术但未行卵巢切除术的绝经前女性与行子宫切除术加双侧卵巢切除术的女性相比，是否有更高的死亡率及未来妇科手术干预的发生率。
我们检索了Cochrane月经紊乱与生育力低下研究组试验注册库（2005年12月至2007年10月）以及以下电子数据库：Cochrane系统评价数据库（2007年第4期）、医学期刊数据库（1966年1月至2007年10月）、荷兰医学文摘数据库（1985年1月至2007年10月）、拉丁美洲和加勒比地区卫生科学数据库（1982年1月至2007年10月）、生物学文摘数据库（1968年1月至2007年10月）、英国国家卫生服务体系经济评价数据库（建库至2007年10月）、卫生技术评估数据库（建库至2007年10月）以及Meta随机对照试验数据库（建库至2007年10月）。我们还检索了相关文章的参考文献列表。
针对患有良性妇科疾病的绝经前女性，比较子宫切除术（采用任何手术方式）未行卵巢切除术与子宫切除术（采用任何手术方式）加双侧卵巢切除术的随机对照试验和对照试验。
三位综述作者独立评估纳入试验，确定研究质量并提取数据。若信息不明确，则与研究作者联系。
在检索到的119项研究中，仅纳入了一项对照试验。因此，进行定量荟萃分析不可行。本研究（有两篇发表文章）纳入了362名女性，其结果以叙述形式总结。未找到随机对照试验。两篇发表文章均未报告本综述中所述的主要结局。该试验显示，在一年随访时，两组在心理健康方面有积极影响的证据质量极低。在所研究的女性群体中，两组在性方面的任何方面均未发现显著差异。
本综述的结论因缺乏数据而受限。需要开展更多方法学质量更高的研究。
