Tchartchian Garri, Bojahr Bernd, Heils Lucas, Krentel Harald, De Wilde Rudy L
Clinic for Minimal Invasive Surgery, 14129 Berlin-Zehlendorf, Germany.
Clinic for Gynecology and Breast Center, Universitätsklinikum Greifswald, 17489 Greifswald, Germany.
J Clin Med. 2022 Dec 30;12(1):296. doi: 10.3390/jcm12010296.
Recent findings suggest that high-grade serous ovarian cancer can originate in the fallopian tube. Not only has that made the identification of precursor lesions pivotal in early detection and prevention of these cancers, prophylactic salpingectomy alongside hysterectomy for benign indications has been increasingly proposed as well. The present prospective single-center study included 273 women who underwent opportunistic salpingectomy alongside laparoscopic supracervical hysterectomy. Uterine and tubal histopathological results as well as intra- and postoperative complications were evaluated. The complication rate was 3.3%, of which none were caused by salpingectomy. Uterine histopathology diagnosed 181 patients (66.8%) with uterine myomas, 60 patients (22.1%) with adenomyosis, 29 patients (10.7%) with adenomyomatosis, and, 1 patient (0.4%) without pathological abnormality. p53 signatures were detected in 221 right fallopian tubes (80.9%) and in 229 left tubes (83.9%). In total, 8 patients showed bilateral STIL (2.9%), whereas in 1 patient (0.4%) STIL was detected in the left tube only. No STIC were detected. Laparoscopic opportunistic salpingectomy is demonstrated to be both safe and feasible. It appears to be promising to reduce the risk for ovarian cancer, yet more studies are needed to undoubtedly confirm this.
近期研究结果表明,高级别浆液性卵巢癌可能起源于输卵管。这不仅使得识别前驱病变对于这些癌症的早期检测和预防至关重要,同时也越来越多地有人提议,对于良性指征的患者,在进行子宫切除术的同时预防性切除输卵管。本前瞻性单中心研究纳入了273例行机会性输卵管切除术及腹腔镜次全子宫切除术的女性。对子宫和输卵管的组织病理学结果以及术中及术后并发症进行了评估。并发症发生率为3.3%,其中无一例由输卵管切除术引起。子宫组织病理学诊断181例患者(66.8%)患有子宫肌瘤,60例患者(22.1%)患有子宫腺肌病,29例患者(10.7%)患有腺肌瘤病,1例患者(0.4%)无病理异常。在221条右侧输卵管(80.9%)和229条左侧输卵管(83.9%)中检测到p53特征。共有8例患者显示双侧输卵管原位癌样病变(STIL,2.9%),而仅在1例患者(0.4%)的左侧输卵管中检测到STIL。未检测到输卵管原位癌(STIC)。腹腔镜机会性输卵管切除术被证明是安全可行的。它似乎有望降低卵巢癌风险,但仍需要更多研究来明确证实这一点。