Deshpande Rasika R, Foy Olivia B, Mandelbaum Rachel S, Roman Lynda D, Dancz Christina E, Wright Jason D, Matsuo Koji
Division of Gynecologic Oncology, the Division of Reproductive Endocrinology & Infertility, and the Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, the Keck School of Medicine, and the Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California; and the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, New York.
Obstet Gynecol. 2023 Dec 1;142(6):1487-1490. doi: 10.1097/AOG.0000000000005405. Epub 2023 Oct 17.
In this cross-sectional study examining 211,708 patients with a diagnosis of uterine prolapse who underwent hysterectomy between 2016 and 2019 identified in the Healthcare Cost and Utilization Project's Nationwide Ambulatory Surgery Sample, co-diagnosis of gynecologic malignancy was reported in 2,398 (1.1%) patients, and they were less likely to receive reconstructive surgery at hysterectomy (odds ratio [OR] 0.90, 95% CI 0.84-0.96). This absence of reconstructive surgery was most pronounced among patients with complete uterine prolapse and gynecologic malignancy (OR 0.68, 95% CI 0.57-0.81). The association was also consistent in coexisting gynecologic premalignancy (n=3,357 [1.6%]). In conclusion, this national-level assessment suggests that patients with uterine prolapse and coexisting gynecologic malignancy or premalignancy may be less likely to receive reconstructive surgery for pelvic floor dysfunction at hysterectomy.
在这项横断面研究中,对2016年至2019年间在医疗成本和利用项目的全国门诊手术样本中确诊为子宫脱垂并接受子宫切除术的211,708名患者进行了检查,结果显示,2398名(1.1%)患者报告有妇科恶性肿瘤合并诊断,这些患者在子宫切除术中接受重建手术的可能性较小(比值比[OR]为0.90,95%置信区间为0.84-0.96)。这种重建手术的缺失在完全性子宫脱垂和妇科恶性肿瘤患者中最为明显(OR为0.68,95%置信区间为0.57-0.81)。在并存妇科癌前病变的患者中(n=3357[1.6%]),这种关联也一致。总之,这项国家级评估表明,患有子宫脱垂并并存妇科恶性肿瘤或癌前病变的患者在子宫切除术中接受盆底功能障碍重建手术的可能性可能较小。