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保留卵巢的阴道输卵管切除术技术。

Vaginal Salpingectomy Techniques in the Presence of Ovarian Conservation.

机构信息

Department of Gynecologic Surgery, Mayo Clinic Arizona, Phoenix, Arizona.

出版信息

J Minim Invasive Gynecol. 2018 Jan;25(1):16. doi: 10.1016/j.jmig.2017.06.012. Epub 2017 Jun 21.

Abstract

STUDY OBJECTIVE

To demonstrate vaginal salpingectomy techniques in the presence of ovarian conservation.

DESIGN

Technical video demonstrating 2 methods of Fallopian tube removal with illustrations (Canadian Task Force classification III).

SETTING

The prevalence of salpingectomy at the time of hysterectomy has increased significantly since 1998 [1]. One reason for the increased rate of salpingectomy is the relationship of serous ovarian carcinomas to fimbrial serous tubal intraepithelial carcinomas [2]. A Swedish population-based study reported that salpingectomy is an effective measure to reduce ovarian cancer risk in the general population [3]. Prophylactic salpingectomy and delayed oophorectomy may be an acceptable alternative in some BRCA mutation carriers [4]. A retrospective cohort study of 425 vaginal hysterectomies showed that 88% of patients were able to successfully undergo concomitant salpingectomy [5]. Mayo Clinic Institutional Review Board approval was not required for this video article.

INTERVENTION

Two methods of salpingectomy are demonstrated differing in the final disposition of the proximal Fallopian tube (segment). The 2 different methods are shown to increase clarity and understanding of the technique.

CONCLUSION

Salpingectomy without concomitant removal of the ovaries at vaginal hysterectomy is a feasible and beneficial procedure.

摘要

目的

展示在保留卵巢的情况下进行阴道输卵管切除术的技术。

设计

技术视频演示了两种输卵管切除方法,并配有插图(加拿大工作组分类 III)。

背景

自 1998 年以来,子宫切除术时输卵管切除术的比例显著增加[1]。输卵管切除术增加的原因之一是浆液性卵巢癌与输卵管壶腹部的浆液性上皮内癌之间的关系[2]。一项瑞典基于人群的研究报告称,输卵管切除术是降低普通人群卵巢癌风险的有效措施[3]。预防性输卵管切除术和延迟卵巢切除术可能是某些 BRCA 基因突变携带者的可接受替代方案[4]。对 425 例阴道子宫切除术的回顾性队列研究表明,88%的患者能够成功同时进行输卵管切除术[5]。本视频文章不需要梅奥诊所机构审查委员会的批准。

干预措施

演示了两种输卵管切除术方法,其区别在于近端输卵管(段)的最终处置。这两种不同的方法旨在提高对该技术的清晰度和理解。

结论

在阴道子宫切除术中不同时切除卵巢的输卵管切除术是一种可行且有益的手术。

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