Resident Physician, Department of Obstetrics & Gynecology, University of North Carolina at Chapel Hill, Chapel Hill.
Assistant Clinical Professor, Department of Obstetrics & Gynecology, University of North Carolina at Chapel Hill; OBGYN Hospitalist and OBGYN Clerkship Director, WakeMed Health & Hospitals, Raleigh, NC.
Obstet Gynecol Surv. 2017 Nov;72(11):663-668. doi: 10.1097/OGX.0000000000000503.
Bilateral salpingectomy reduces the risk ovarian cancer. The Society of Gynecologic Oncology has recommended surgeons discuss salpingectomy with patients desiring sterilization.
This review summarizes current literature on the benefits and risks of bilateral salpingectomy to reduce ovarian cancer risk. Areas of insufficient evidence and directions for further research are discussed.
We examined the benefits and risks of bilateral salpingectomy for female surgical sterilization, using a PubMed and EMBASE literature review. Search parameters included articles in English language and keywords "salpingectomy" or "ovarian cancer" combined with "contraception," "sterilization," or "tubal ligation."
We reviewed 4 high-quality studies that investigated the increased risk reduction of bilateral salpingectomy compared with traditional sterilization. Overall, evidence shows that salpingectomy moderately decreases the risk of ovarian cancer compared with traditional sterilization. An additional 4 studies, including a meta-analysis, showed salpingectomy likely does not have significant long-term impact on ovarian reserve. Additional benefits include improved contraceptive efficacy and elimination of subsequent ectopic pregnancies. Risks include need for in vitro fertilization for patients experiencing sterilization regret, increases in operative time, and potential increases in surgical risks.
Bilateral salpingectomy can reduce ovarian cancer risk compared with traditional sterilization; however, research regarding other outcomes is limited. Challenges to implementation include physician concern regarding surgical risks and patient education. Studies investigating patient-based outcomes are lacking.
Bilateral salpingectomy for surgical sterilization is a reasonable option when patients are appropriately informed. Ovarian cancer risk reduction should be one of several factors considered when patients choose a surgical sterilization method.
双侧输卵管切除术可降低卵巢癌风险。妇科肿瘤学协会建议外科医生与希望绝育的患者讨论输卵管切除术。
本综述总结了目前关于双侧输卵管切除术降低卵巢癌风险的益处和风险的文献。讨论了证据不足的领域和进一步研究的方向。
我们使用 PubMed 和 EMBASE 文献检索，检查了双侧输卵管切除术对女性绝育的益处和风险。搜索参数包括英语语言的文章和关键词“输卵管切除术”或“卵巢癌”，与“避孕”、“绝育”或“输卵管结扎”相结合。
我们回顾了 4 项高质量的研究，这些研究调查了与传统绝育相比，双侧输卵管切除术增加的风险降低。总的来说，证据表明输卵管切除术与传统绝育相比，可适度降低卵巢癌的风险。另外 4 项研究，包括一项荟萃分析，表明输卵管切除术可能对卵巢储备没有显著的长期影响。额外的益处包括提高避孕效果和消除随后的宫外孕。风险包括因绝育后悔而需要体外受精的患者，手术时间增加，以及手术风险增加的潜在增加。
与传统绝育相比，双侧输卵管切除术可降低卵巢癌风险；然而，关于其他结果的研究有限。实施面临的挑战包括医生对手术风险的担忧和患者教育。缺乏以患者为基础的研究。当患者得到适当的告知时，双侧输卵管切除术用于绝育是一个合理的选择。降低卵巢癌风险应是患者选择绝育方法时需要考虑的几个因素之一。
