Obermair Helena M, Borg Emma J
Liverpool Hospital, South-West Sydney Local Health District, Sydney, New South Wales, Australia.
University of New South Wales, Sydney, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2019 Oct;59(5):725-729. doi: 10.1111/ajo.13022. Epub 2019 Jul 8.
Given that a significant percentage of high-grade serous cancers develop in the fallopian tube, it has been suggested that salpingectomy may prevent some of these malignancies. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines recommend prophylactic salpingectomy to be discussed with or offered to patients undergoing hysterectomy for benign indications. This study compares rates of salpingectomy at the time of hysterectomy for benign indications across different surgical approaches among Australian and New Zealand gynaecologists. Data were collected via SurgicalPerformance, a web-based surgical outcomes review and feedback software used by independent gynaecologic surgeons. Of 11 477 hysterectomy records available, 6608 were eligible for analysis. Rates of salpingectomy at vaginal hysterectomy (13%) were significantly lower (P < 0.001) compared to open abdominal (65%), laparoscopic (70%), laparoscopic-assisted vaginal (78%), or robotic hysterectomies (73%) and also lower than in hysterectomies converted to an open abdominal approach (73%).
鉴于相当比例的高级别浆液性癌发生在输卵管，有人提出输卵管切除术可能预防其中一些恶性肿瘤。澳大利亚和新西兰皇家妇产科医师学院的指南建议，对于因良性指征接受子宫切除术的患者，应与其讨论或提供预防性输卵管切除术。本研究比较了澳大利亚和新西兰妇科医生在不同手术方式下因良性指征行子宫切除术时的输卵管切除率。数据通过SurgicalPerformance收集，这是一款独立妇科外科医生使用的基于网络的手术结果回顾和反馈软件。在11477份可用的子宫切除术记录中，6608份符合分析条件。阴道子宫切除术的输卵管切除率（13%）显著低于开腹手术（65%）、腹腔镜手术（70%）、腹腔镜辅助阴道手术（78%）或机器人辅助子宫切除术（73%），也低于转为开腹手术的子宫切除术（73%）（P<0.001）。
