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良性妇科手术及剖宫产术中的偶然(预防性)输卵管切除术:奥地利的实践调查

Incidental (Prophylactic) Salpingectomy at Benign Gynecologic Surgery and Cesarean Section: a Survey of Practice in Austria.

作者信息

Potz F L, Tomasch G, Polterauer S, Laky R, Marth C, Tamussino K

机构信息

Division of Gynecology, Department of Obstetrics & Gynecology, Medical University of Graz, Graz, Austria.

Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics & Gynecology, Medical University of Vienna, Vienna, Austria.

出版信息

Geburtshilfe Frauenheilkd. 2016 Dec;76(12):1325-1329. doi: 10.1055/s-0042-116493.

Abstract

Most serous ovarian cancers are now thought to originate in the fallopian tubes. This has raised the issue of performing incidental salpingectomy (also called elective, opportunistic, prophylactic or risk-reducing salpingectomy) at the time of benign gynecologic surgery or cesarean section. We conducted an online survey to ascertain the policies regarding incidental salpingectomy in Austria in late 2014. All 75 departments of obstetrics and gynecology in public hospitals in Austria were surveyed for their policies regarding incidental salpingectomy at benign gynecologic surgery or cesarean section. Sixty-six of 75 surveyed departments completed the questionnaire, resulting in a response rate of 88 %. Overall, 46 of 66 (70 %) units reported offering or recommending incidental salpingectomy at benign gynecologic surgery, 12 units (18 %) did not, and eight units (12 %) did not have a consistent policy. Salpingectomy was the preferred method for surgical sterilization, including sterilization at the time of cesarean section (71 % and 64 % of units, respectively). Incidental (elective, opportunistic, prophylactic, risk-reducing) salpingectomy is now widely offered at benign gynecologic surgery and cesarean section in Austria. Evidence for the role of the fallopian tubes in the origin of serous pelvic cancer has led to changes in clinical practice.

摘要

目前大多数浆液性卵巢癌被认为起源于输卵管。这引发了在良性妇科手术或剖宫产时进行附带输卵管切除术(也称为选择性、机会性、预防性或降低风险的输卵管切除术)的问题。我们于2014年末进行了一项在线调查,以确定奥地利关于附带输卵管切除术的政策。对奥地利公立医院的所有75个妇产科科室就其在良性妇科手术或剖宫产时进行附带输卵管切除术的政策进行了调查。75个被调查科室中有66个完成了问卷,回复率为88%。总体而言,66个科室中有46个(70%)报告在良性妇科手术时提供或推荐附带输卵管切除术,12个科室(18%)不提供,8个科室(12%)没有一致的政策。输卵管切除术是手术绝育的首选方法,包括剖宫产时的绝育(分别为71%和64%的科室)。在奥地利,附带(选择性、机会性、预防性、降低风险的)输卵管切除术目前在良性妇科手术和剖宫产中广泛施行。输卵管在浆液性盆腔癌起源中的作用的证据已导致临床实践的改变。

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