摘要
目的通过被切除输卵管的术后病理分析探讨因子宫良性疾病行(腹腔镜)全子宫切除术或次全子宫切除术的患者同时切除双侧输卵管的临床应用价值。方法回顾性分析四川大学华西第二医院妇科2010年12月至2015年12月收治的因子宫平滑肌瘤、腺肌症等良性病变行(腹腔镜)全子宫或次全子宫切除术同时行输卵管切除术的1 272例患者临床病理资料,分析术后组织病理检查结果。结果 1 272例患者中,其中行双侧输卵管切除术1 226例,单侧输卵管切除术46例。334例患者有附件区压痛体征(26.26%),401例患者有附件区增厚体征(31.53%)。共切除输卵管2 498条,腔镜下或手术中肉眼观可见1 654条输卵管外观无明显异常(66.21%),636条输卵管管腔部分隆起(25.46%),128条输卵管红肿(5.12%),80条输卵管管腔萎缩粘连表现(3.20%);术后病理结果为2 386条(95.52%)输卵管有慢性输卵管炎症,988条(39.55%)输卵管囊肿,80条(3.20%)正常输卵管,78条(3.12%)输卵管积液,48条(1.92%)输卵管有炎性增生表现,8条(0.32%)输卵管黏膜上皮非典型增生改变、4条(0.26%)输卵管良性肿瘤及2条(0.08%)输卵管癌变。在10例输卵管癌、输卵管非典型增生患者中,发现8例患者对侧输卵管普遍存在明显慢性炎症的改变,其中输卵管非典型增生7例,输卵管癌1例。结论预防性输卵管切除可治疗输卵管炎性病变,去除癌变诱因。
Objective To explore the clinical value of resection of bilateral fallopian tubes in patients with benign uterine diseases who received （laparoscopic） hysterectomy or subhysterectomy through the postoperative pathologic analysis of resected fallopian tubes. Methods A retrospective analysis was conducted to review the histopathological examination results in 1 272 women who underwent （laparoscopic） total hysterectomy or subtotal hysterectomy and the removal of bilateral fallopian tube simultaneously due to uterine leiomyoma, adenomyosis and other benign lesions from December 2010 to December 2015. Results Of the 1 272 patients, laparoscopic resection was underwent in 1 005 patients （79.01%） and laparotomy in 267 patients （20.99%）. In the attachment area, 334 patients （26.26%） had tenderness signs, and 401 patients （31.53%） had signs of thickening. Total 2 498 fallopian tubes were removed. There were 1 654 tubal with no obvious abnormal appearance （66.21%）, 636 tubal with lumen part of the uplift （25.46%）, 128 fallopian tube with congestion and swelling （5.12%）, 80 fallopian tube atrophy adhesions （3.20%）. Pathological results showed 2 386 （95.52%） fallopian tubes with chronic fallopian tube inflammation, 988 （39.55%） of fallopian tube cyst, 80 （3.20%） of normal fallopian tube, 78 （3.12%） of tubal effusion, 48 （1.92% ） of tubal hyperplasia, 4 （0.26%） of tubal benign tumor, 8 （0.32%） of tubal mucosa atypical hyperplasia change and 2（0.08%） of tubal cancer. In the 10 cases of fallopian tube cancer and atypical hyperplasia, 8 had obvious changes of chronic inflammation in the contralateral fallopian tube, including 7 cases of atypical hyperplasia and 1 case of fallopian tube cancer. Conclusion Prophylactic salpingectomy can prevent the occurrence of tubal inflammation and removal cancer incentives.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2017年第2期314-317,共4页
Journal of Sichuan University(Medical Sciences)
关键词
预防性输卵管切除
输卵管癌
输卵管炎症
非典型增生
Prophylactic salpingectomy Fallopian tube carcinoma Tubal inflammation Atypical hyperplasia
