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在进行腹部手术矫正盆腔器官脱垂和尿失禁时实施预防性输卵管卵巢切除术的可行性。

Feasibility of Risk Reducing Salpingo-Oophorectomy at the Time of Abdominal Surgery for Correction of Pelvic Organ Prolapse and Urinary Incontinence.

作者信息

Azadi Ali, Bradley James A, Marchand Greg J, Lorenz Douglas J, Doering David, Ostergard Donald R

机构信息

Department of Obstetrics/Gynecology, University of Arizona College of Medicine, Phoenix, USA.

Star Urogynecology, Advanced Pelvic Health Institute for Women, Peoria, USA.

出版信息

Gynecol Minim Invasive Ther. 2021 Jan 30;10(1):10-18. doi: 10.4103/GMIT.GMIT_21_20. eCollection 2021 Jan-Mar.

Abstract

OBJECTIVE

The objective of this study is to assess the perioperative outcomes when prophylactic bilateral salpingo-oophorectomy (BSO) is performed concomitantly with surgery to repair pelvic organ prolapse (POP) or stress urinary incontinence (SUI).

MATERIALS AND METHODS

This is a retrospective case-control study of patients who underwent abdominal surgery for the correction of POP and/or SUI with or without concomitant BSO at a tertiary care center. The primary outcome measures were postsurgery length of hospitalization, estimated blood loss, and 30-day readmission rate. The secondary outcome measure was detection of ovarian cancer precursor lesions.

RESULTS

We identified 734 patients who had surgery for POP and/or SUI. The control group contained 385 patients, and the BSO group contained 349 patients. There was no difference between the control and BSO groups in the postsurgery length of stay (LOS) (35.2 h vs. 34.1 h; = 0.49), and all-cause 30-day readmission rate (14.2% vs. 11.6%; = 0.3085). However, there was decreased blood loss (40.8 ml vs. 67.2 ml, < 0.0001) in the BSO group compared to the control group. Sub-analysis of primary outcomes in postmenopausal women (age > 55) showed decreased postsurgery LOS (33.4 h vs. 37.4 h; = 0.0208) and decreased blood loss (35.9 ml vs. 82.7 ml; < 0.0001) in the BSO group compared to control.

CONCLUSION

Secondary to the lack of additional complications, we recommend surgeons give more consideration to finding appropriate candidates for a risk reducing BSO at time of abdominal surgery to repair POP or SUI.

摘要

目的

本研究的目的是评估在进行盆腔器官脱垂(POP)修复术或压力性尿失禁(SUI)手术的同时进行预防性双侧输卵管卵巢切除术(BSO)的围手术期结局。

材料与方法

这是一项回顾性病例对照研究,研究对象为在三级医疗中心接受腹部手术以矫正POP和/或SUI且伴有或不伴有BSO的患者。主要结局指标为术后住院时间、估计失血量和30天再入院率。次要结局指标为卵巢癌前驱病变的检测。

结果

我们确定了734例接受POP和/或SUI手术的患者。对照组有385例患者,BSO组有349例患者。对照组和BSO组在术后住院时间(LOS)(35.2小时对34.1小时;P = 0.49)和全因30天再入院率(14.2%对11.6%;P = 0.3085)方面没有差异。然而,与对照组相比,BSO组的失血量减少(40.8毫升对67.2毫升,P < 0.0001)。对绝经后女性(年龄>55岁)的主要结局进行亚分析显示,与对照组相比,BSO组的术后住院时间缩短(33.4小时对37.4小时;P = 0.0208),失血量减少(35.9毫升对82.7毫升;P < 0.0001)。

结论

由于没有额外的并发症,我们建议外科医生在进行腹部手术修复POP或SUI时,更多地考虑寻找合适的患者进行降低风险的BSO。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8bd/7968605/d59dc51a9b26/GMIT-10-10-g001.jpg

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