Division of Women's Services, Legacy Health System, Portland, Oregon.
Divisions of Gynecologic Oncology, Legacy Medical Group, Portland, Oregon.
J Minim Invasive Gynecol. 2018 Nov-Dec;25(7):1179-1193. doi: 10.1016/j.jmig.2017.10.025. Epub 2017 Oct 31.
This review article discusses cancer risk-reducing opportunities in gynecologic surgery. We cover strategies to reduce ovarian and uterine cancer risk by presenting general practice guidelines and expanding on the literature behind clinical decision points. We address populations of women at increased hereditary risk and those at population risk. We specifically discuss risk-reducing salpingo-oophorectomy, prophylactic salpingectomy with delayed oophorectomy, concomitant hysterectomy, opportunistic salpingectomy, bilateral tubal ligation, and hysterectomy. For clinical scenarios in which data are limited or conflicting, we detail the studies on which clinicians' decisions hinge to allow the reader to weigh the available evidence.
这篇综述文章讨论了妇科手术中的癌症风险降低机会。我们通过介绍一般实践指南并扩展临床决策点背后的文献，讨论了通过妇科手术降低卵巢癌和子宫体癌风险的策略。我们针对遗传性风险增加的女性人群和具有人群风险的女性人群进行了讨论。我们特别讨论了降低风险的输卵管卵巢切除术、预防性输卵管切除术伴延迟卵巢切除术、同期子宫切除术、机会性输卵管切除术、双侧输卵管结扎术和子宫切除术。对于数据有限或存在冲突的临床情况，我们详细介绍了决定临床医生决策的研究，以便读者权衡可用证据。
