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BRCA1/2 突变携带者中预防性输卵管卵巢切除术的短期手术结果和安全性。

Short-term surgical outcome and safety of risk reducing salpingo-oophorectomy in BRCA1/2 mutation carriers.

机构信息

Department of Gynaecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Maturitas. 2010 Jul;66(3):310-4. doi: 10.1016/j.maturitas.2010.03.018. Epub 2010 Apr 21.

Abstract

OBJECTIVE

Women with a BRCA1/2 mutation or members of a hereditary breast ovarian cancer family (HBOC) have an increased risk of developing ovarian cancer. The only effective strategy to reduce this risk is a risk reducing salpingo-oophorectomy (RRSO). The aim of this study was to evaluate the short-term surgical outcome and safety of a RRSO.

PATIENT AND METHODS

Included were all consecutive women with a BRCA1/2 mutation or members of a HBOC family who visited our Family Cancer Clinic between September 1995 and March 2006, and choose for RRSO.

RESULTS

159 women were included, of which 97 (61.0%) BRCA1 and 32 (20.1%) BRCA2 mutation carriers, and 30 women of a HBOC family (18.9%). The median age at RRSO was 42.9 years (30.3-61.1) in the BRCA1 group, 48.4 years (33.5-66.9) in the BRCA 2 group and 46.4 (32.8-68.7) years in the HBOC group (p=0.02). The median body mass index (BMI) was 24.9 kg/m(2), 30.1% were overweighed (BMI 25-30) and 18.7% were obese (BMI>30). The RRSO was performed by primary laparoscopy (n=154) or laparotomy (n=5). Intraoperatively, one (0.6%) major complication occurred and laparoscopy was converted to laparotomy. In one patient (0.6%) a minor complication occurred. Post-operatively five minor complications (3.1%) were observed. Median hospital stay was 1 day (0-13 days).

CONCLUSION

Laparoscopic RRSO in BRCA1/2 mutation carriers seems to be a safe procedure with a low intraoperative and post-operative complication rate (1.3% and 3.1% respectively), a low conversion rate (0.6%) and a short median hospital stay (1.0 day).

摘要

目的

携带 BRCA1/2 突变或遗传性乳腺癌卵巢癌家族(HBOC)成员的女性发生卵巢癌的风险增加。降低这种风险的唯一有效策略是进行风险降低的输卵管卵巢切除术(RRSO)。本研究旨在评估 RRSO 的短期手术结果和安全性。

患者和方法

纳入了 1995 年 9 月至 2006 年 3 月期间在我们的家族癌症诊所就诊并选择 RRSO 的携带 BRCA1/2 突变或 HBOC 家族成员的所有连续女性。

结果

共纳入 159 名女性,其中 97 名(61.0%)为 BRCA1 突变携带者,32 名(20.1%)为 BRCA2 突变携带者,30 名(18.9%)为 HBOC 家族成员。BRCA1 组 RRSO 的中位年龄为 42.9 岁(30.3-61.1),BRCA2 组为 48.4 岁(33.5-66.9),HBOC 组为 46.4 岁(32.8-68.7)(p=0.02)。中位体重指数(BMI)为 24.9kg/m2,30.1%超重(BMI 25-30),18.7%肥胖(BMI>30)。RRSO 由腹腔镜(n=154)或剖腹手术(n=5)完成。术中发生 1 例(0.6%)重大并发症,腹腔镜转为剖腹手术。1 例(0.6%)患者发生 1 例轻微并发症。术后观察到 5 例(3.1%)轻微并发症。中位住院时间为 1 天(0-13 天)。

结论

BRCA1/2 突变携带者的腹腔镜 RRSO 似乎是一种安全的手术,术中及术后并发症发生率低(分别为 0.6%和 3.1%),中转开腹率低(0.6%),中位住院时间短(1 天)。

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