中年女性机会性子宫或附件切除:利与弊

Selective Removal of Uterus or Bilateral Adnexa of Middle-aged Female: Advantages and Disadvantages

  • 摘要: 近年来,随着人们生活质量的提高及对疾病认知的加深,机会性子宫或附件切除已成为临床医生及患者关注的热点问题。本文通过回顾现有研究证据,进行利弊分析,指出全子宫切除术可降低宫颈癌或子宫内膜癌高危人群发病风险,但有可能对患者的盆底功能、性生活满意度及心理产生负面影响。中年女性绝经后因附件良性肿物在切除患侧附件时,是否同时行机会性全子宫切除,需考虑患者宫颈癌及子宫内膜癌发病风险、周身状况及术者经验,在与患者及家属充分协商的基础上综合评估;对因良性疾病而计划行子宫切除术的女性,应考虑进行机会性输卵管切除术,以降低上皮性卵巢癌的发病率,但对已确诊乳腺癌患者,如计划行子宫切除术,应行机会性双侧附件切除,以降低乳腺癌的死亡率。

     

    Abstract: In recent years, with the improvement of people's quality of life and the deepening of the understanding of the disease, opportunistic hysterectomy or adnexal resection has become a hot issue of concern to clinicians and patients. In this paper, based on the analysis of the advantages and disadvantages of hysterectomy, it is pointed out that hysterectomy can reduce the risk of cervical cancer or endometrial cancer in the high-risk group, but it may have negative effects on pelvic floor function, sexual satisfaction, and psychology. Whether selecting hysterectomy should be performed at the same time of the salpingo-oophorectomy for postmenopausal patients, several factors should be considered at the same time, including: the risk of cervical cancer and endometrial cancer, the patient's physical condition, and the experience of the surgeon. Opportunistic salpingectomy should be considered for women scheduled for hysterectomy due to benign disease in order to reduce the incidence of epithelial ovarian cancer. However, bilateral salpingo-oophorectomy should be performed in patients diagnosed with breast cancer if hysterectomy is planned in order to reduce the mortality of breast cancer.

     

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