Kim Miseon, Kim Young-Han, Kim Yong Beom, Kim Jayeon, Kim Jae-Weon, Park Mi Hye, Park Joo Hyun, Rhee Jeong Ho, Lim Myong Cheol, Hong Joon-Seok
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2018 Sep;61(5):542-552. doi: 10.5468/ogs.2018.61.5.542. Epub 2018 Sep 7.
Based on the current understanding of a preventive effect of bilateral salpingectomy on ovarian/fallopian/peritoneal cancers, the Korean Society of Obstetrics and Gynecology, Korean Society of Gynecologic Endocrinology, Korean Society of Gynecologic Oncology, Korean Society of Maternal Fetal Medicine, and Korean Society for Reproductive Medicine support the following recommendations: • Women scheduled for hysterectomy for benign gynecologic disease should be informed that bilateral salpingectomy reduces the risk of ovarian/fallopian/peritoneal cancer, and they should be counseled regarding this procedure at the time of hysterectomy. • Although salpingectomy is generally considered as a safe procedure in terms of preserving ovarian reserve, there is a lack of evidences representing its long-term outcomes. Therefore, patients should be informed about the minimal potential of this procedure for decreasing ovarian reserve. • Prophylactic salpingectomy during vaginal hysterectomy is favorable in terms of prevention of ovarian/fallopian/peritoneal cancer, although operation-related complications minimally increase with this procedure, compared to the complications associated with vaginal hysterectomy alone. Conversion to open or laparoscopic approach from vaginal approach to perform prophylactic salpingectomy is not recommended. • Women who desire permanent sterilization at the time of cesarean delivery could be counseled for prophylactic salpingectomy before surgery on an individual basis.
基于目前对双侧输卵管切除术对卵巢癌/输卵管癌/腹膜癌预防作用的认识,韩国妇产科协会、韩国妇科内分泌学会、韩国妇科肿瘤学会、韩国母胎医学学会和韩国生殖医学学会支持以下建议:
• 计划因良性妇科疾病行子宫切除术的女性应被告知双侧输卵管切除术可降低卵巢癌/输卵管癌/腹膜癌的风险,并且应在子宫切除术时就该手术对其进行咨询。
• 尽管输卵管切除术在保留卵巢储备方面通常被认为是一种安全的手术,但缺乏表明其长期效果的证据。因此,应告知患者该手术降低卵巢储备的潜在可能性极小。
• 经阴道子宫切除术时行预防性输卵管切除术在预防卵巢癌/输卵管癌/腹膜癌方面是有利的,尽管与单纯经阴道子宫切除术相关的并发症相比,该手术相关并发症会略有增加。不建议从经阴道途径转换为开放或腹腔镜途径来进行预防性输卵管切除术。
• 对于剖宫产时希望永久绝育的女性,可在术前根据个人情况就预防性输卵管切除术进行咨询。