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子宫切除术后未行卵巢切除术与单侧卵巢切除术治疗良性疾病后继发性卵巢病变的发生情况:一项对患者进行九年观察期的回顾性分析。

Development of secondary ovarian lesions after hysterectomy without oophorectomy versus unilateral oophorectomy for benign conditions: a retrospective analysis of patients during a nine-year period of observation.

作者信息

Baloglu A, Bezircioglu I, Cetinkaya B, Karci L, Bicer M

机构信息

Department of Obstetrics and Gynecology, Ataturk Training and Research Hospital, Izmir, Turkey.

出版信息

Clin Exp Obstet Gynecol. 2010;37(4):299-302.

Abstract

PURPOSE

The effect of retained one or both ovaries on the de novo ovarian pathologies required re-operation after hysterectomy due to benign gynecologic conditions were investigated retrospectively. This study was done to determine the occurrence of disease in retained ovaries after hysterectomy.

METHODS

A retrospective analysis of patient charts was performed, comparing the patient reports of women who had secondary ovarian lesions those whose previously undergone total abdominal hysterectomy with unilateral oophorectomy or without oophorectomy in our Department during the nine year period of observation (2000-2009). The study included 1242 women with at least one ovary saved after hysterectomy for benign indications.

RESULTS

De novo ovarian disease was established in 5.1% of patients of hysterectomy without oophorectomy and in 17.6% of patients of at least one ovary saved after hysterectomy for benign indications (p = 0.005). Ovarian pathology requiring re-operation developed in 3.8% of patients who underwent hysterectomy without oophorectomy and in 5.9% of patients who underwent hysterectomy with unilateral oophorectomy (p = 0.536).

CONCLUSION

Women with unilateral oophorectomy at the time of hysterectomy had more than twice the risk of secondary ovarian lesions, compared with those without oophorectomy at hysterectomy. Determinants, such as age, parity and gravidity must be considered when deciding whether or not to perform oophorectomy at hysterectomy.

摘要

目的

回顾性研究保留一侧或双侧卵巢对因良性妇科疾病行子宫切除术后需再次手术的新发卵巢病变的影响。本研究旨在确定子宫切除术后保留卵巢中疾病的发生率。

方法

对患者病历进行回顾性分析,比较在9年观察期(2000 - 2009年)内,我科既往接受全腹子宫切除术加单侧卵巢切除术或未行卵巢切除术的女性患者中,出现继发性卵巢病变的情况。该研究纳入了1242例因良性指征行子宫切除术后至少保留一侧卵巢的女性。

结果

未行卵巢切除术的子宫切除患者中,5.1%发生了新发卵巢疾病;因良性指征行子宫切除术后至少保留一侧卵巢的患者中,17.6%发生了新发卵巢疾病(p = 0.005)。未行卵巢切除术的子宫切除患者中,3.8%出现了需要再次手术的卵巢病变;行单侧卵巢切除术的子宫切除患者中,5.9%出现了需要再次手术的卵巢病变(p = 0.536)。

结论

与子宫切除时未行卵巢切除术的女性相比,子宫切除时行单侧卵巢切除术的女性发生继发性卵巢病变的风险高出两倍多。在决定子宫切除时是否行卵巢切除术时,必须考虑年龄、产次和妊娠等因素。

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