Madueke-Laveaux Obianuju Sandra, Elsharoud Amro, Al-Hendy Ayman
Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA.
Department of Family Medicine, Texas Tech University Health and Science Center, Lubbock, TX 79430, USA.
J Clin Med. 2021 Nov 16;10(22):5335. doi: 10.3390/jcm10225335.
Hysterectomy is the most common treatment option in women with uterine fibroids, providing definitive relief from the associated burdensome symptoms. As with all surgical interventions, hysterectomy is associated with risk of complications, short-term morbidities, and mortality, all of which have been described previously. However, information on the potential long-term risks of hysterectomy is only recently becoming available. A systematic literature review was performed to identify studies published between 2005 and December 2020 evaluating the long-term impact of hysterectomy on patient outcomes. A total of 29 relevant studies were identified. A review of the articles showed that hysterectomy may increase the risk of cardiovascular events, certain cancers, the need for further surgery, early ovarian failure and menopause, depression, and other outcomes. It is important to acknowledge that the available studies examine possible associations and hypotheses rather than causality, and there is a need to establish higher quality studies to truly evaluate the long-term consequences of hysterectomy. However, it is of value to consider these findings when discussing the benefits and risks of all treatment options with patients with uterine fibroids to allow for preference-based choices to be made in a shared decision-making process. This is key to ensuring that patients receive the treatment that best meets their individual needs.
子宫切除术是子宫肌瘤女性最常见的治疗选择，能有效缓解相关的繁重症状。与所有外科手术一样，子宫切除术存在并发症、短期发病率和死亡率的风险，所有这些之前都已有描述。然而，关于子宫切除术潜在长期风险的信息直到最近才开始出现。进行了一项系统的文献综述，以确定2005年至2020年12月期间发表的评估子宫切除术对患者预后长期影响的研究。共确定了29项相关研究。对这些文章的综述表明，子宫切除术可能会增加心血管事件、某些癌症、进一步手术需求、早期卵巢功能衰竭和更年期、抑郁症及其他预后的风险。必须认识到，现有研究考察的是可能的关联和假设而非因果关系，需要开展更高质量的研究来真正评估子宫切除术的长期后果。然而，在与子宫肌瘤患者讨论所有治疗选择的益处和风险时，考虑这些发现以便在共同决策过程中做出基于偏好的选择是有价值的。这是确保患者接受最符合其个人需求的治疗的关键。
