Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.
BMJ Open. 2013 Jun 20;3(6):e002845. doi: 10.1136/bmjopen-2013-002845.
To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation.
A historical cohort study.
Denmark.
170 000 randomly selected women born 1947-1963 (10 000/year) were followed from 1977 until the end of 2010.
Effect of hysterectomy with retained fallopian tubes or sterilisation on the risk of salpingectomy. Both were modelled in a Cox proportional hazards model as time-dependent covariates, analysing time to first salpingectomy. End of follow-up period was 31 December 2010.
Of 9591 hysterectomies, 6456 (67.3%) had both fallopian tubes retained. HRs for salpingectomy after hysterectomy with retained fallopian tubes and sterilisation were 2.13 (95% 1.88 to 2.42) and 2.42 (2.21 to 2.64), as compared with those for non-hysterectomised and non-sterilised women.
Women undergoing hysterectomy with retained fallopian tubes or sterilisation have at least a doubled risk of subsequent salpingectomy. Removal of the fallopian tubes at hysterectomy should therefore be recommended.
评估初次输卵管切除术的风险是否受保留输卵管的子宫切除术和先前绝育的影响。
历史队列研究。
丹麦。
1947 年至 1963 年随机选择的 170000 名女性（每年 10000 名），从 1977 年随访至 2010 年底。
保留输卵管的子宫切除术或绝育对输卵管切除术风险的影响。两者均作为时间依赖性协变量在 Cox 比例风险模型中建模，分析首次输卵管切除术的时间。随访期结束日期为 2010 年 12 月 31 日。
在 9591 例子宫切除术中，有 6456 例（67.3%）保留了双侧输卵管。与未行子宫切除术和未绝育的女性相比，保留输卵管的子宫切除术和绝育后的输卵管切除术的 HR 分别为 2.13（95%置信区间 1.88 至 2.42）和 2.42（2.21 至 2.64）。
行保留输卵管的子宫切除术或绝育的女性随后行输卵管切除术的风险至少增加了一倍。因此，建议在子宫切除术中切除输卵管。
