Ely L Kirsten, Truong Mireille
Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System, Richmond, Virginia.
Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System, Richmond, Virginia.
J Minim Invasive Gynecol. 2017 Mar-Apr;24(3):371-378. doi: 10.1016/j.jmig.2017.01.001. Epub 2017 Jan 10.
Bilateral tubal ligation (BTL) for sterilization has been known to decrease the risk of ovarian cancer. Recent studies have suggested that bilateral salpingectomy (BS) may be an alternative to BTL or tubal occlusion for women desiring permanent sterilization, owing to a possibly greater protective effect against ovarian cancer. We conducted a PubMed/MEDLINE review of the literature for original studies, opinion articles, and meta-analyses published between 2010 and 2016 addressing the role of BS at the time of sterilization and comparing its efficacy with BTL in terms of ovarian cancer prevention, operative outcomes, and ovarian function. BTL has been found to decrease the risk of any ovarian cancer by 13% to 41%, compared with 42% to 78% for BS. Although operative time is increased with BS compared with BTL, no differences in complication rates or ovarian reserve between the 2 procedures have been demonstrated. Our review suggests that BS should be discussed when BTL is being considered, and that patients should be counseled about the risks and benefits of both procedures based on the current available evidence.
双侧输卵管结扎术（BTL）用于绝育已被证实可降低卵巢癌风险。近期研究表明，对于希望永久绝育的女性，双侧输卵管切除术（BS）可能是BTL或输卵管闭塞术的替代方法，因为其对卵巢癌可能具有更强的保护作用。我们对PubMed/MEDLINE上2010年至2016年间发表的关于BS在绝育时的作用以及在预防卵巢癌、手术结果和卵巢功能方面与BTL疗效比较的原始研究、观点文章和荟萃分析进行了文献综述。已发现BTL可使任何卵巢癌风险降低13%至41%，而BS为42%至78%。虽然与BTL相比，BS的手术时间会增加，但两种手术在并发症发生率或卵巢储备方面未显示出差异。我们的综述表明，在考虑BTL时应讨论BS，并且应根据现有证据向患者咨询两种手术的风险和益处。
