Paul P G, Mannur Sumina, Shintre Hemant, Paul George, Gulati Gunjan, Mehta Santwan
Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Vattekkattu Road, Kaloor, Kochi, Kerala 682 017 India.
J Obstet Gynaecol India. 2018 Aug;68(4):314-319. doi: 10.1007/s13224-018-1131-7. Epub 2018 May 16.
Opportunistic bilateral salpingectomy (OBS), also called as prophylactic salpingectomy or risk-reducing salpingectomy is the concurrent removal of the fallopian tubes in premenopausal women. Though there are some studies comparing the intraoperative complications and effect of salpingectomy on ovarian reserve, limited data are available on long-term follow-up after OBS.
To evaluate the surgical outcome of routine bilateral salpingectomy during total laparoscopic hysterectomy (TLH) in terms of intraoperative and postoperative complications. We also evaluated the incidence and reoperation rate for adnexal pathology after TLH.
A retrospective study of 1470 patients undergoing total laparoscopic hysterectomy (TLH) with opportunistic bilateral salpingectomy (OBS) over 13 years was carried out at Paul's Hospital.
The mean age of the subjects was 43.6 ± 4.2 years, mean body mass index was 27 ± 5.4 kg/m, and median parity was 2 (range 0-7). 43% of women had at least one previous surgery. The most common indication for surgery was fibroid uterus (67%, = 985). The total complication rate was 4.4% ( = 65). One specimen showed paratubal borderline serous malignancy. The follow-up period ranged from 6 months to 13 years during which 17 (1.1%) women had adnexal pathology, and eight women (1.1%) needed resurgery for it. No ovarian malignancies were reported on follow-up.
OBS is a simple and short surgical step during TLH without increasing morbidity. OBS eliminates the risk of future diseases of tubal origin, and there might be a possible reduction in incidence and reoperation rate for future ovarian pathologies.
机会性双侧输卵管切除术（OBS），也称为预防性输卵管切除术或降低风险的输卵管切除术，是指在绝经前女性中同时切除双侧输卵管。尽管有一些研究比较了输卵管切除术的术中并发症以及对卵巢储备功能的影响，但关于OBS术后长期随访的数据有限。
从术中及术后并发症方面评估全腹腔镜子宫切除术（TLH）中常规双侧输卵管切除术的手术结果。我们还评估了TLH术后附件病变的发生率及再次手术率。
在保罗医院对1470例在13年期间接受全腹腔镜子宫切除术（TLH）并进行机会性双侧输卵管切除术（OBS）的患者进行了一项回顾性研究。
研究对象的平均年龄为43.6±4.2岁，平均体重指数为27±5.4kg/m²，中位产次为2次（范围0 - 7次）。43%的女性既往至少接受过一次手术。最常见的手术指征是子宫肌瘤（67%，n = 985）。总并发症发生率为4.4%（n = 65）。一份标本显示输卵管旁交界性浆液性恶性肿瘤。随访期为6个月至13年，在此期间17例（1.1%）女性出现附件病变，8例（1.1%）女性因此需要再次手术。随访期间未报告卵巢恶性肿瘤。
OBS是TLH过程中一个简单且耗时短的手术步骤，不会增加发病率。OBS消除了未来输卵管源性疾病的风险，并且可能会降低未来卵巢病变的发生率及再次手术率。
