Total salpingectomy during abdominal hysterectomy: Effects on ovarian reserve and ovarian stromal blood flow
Total salpingectomy during abdominal hysterectomy: Effects on ovarian reserve and ovarian stromal blood flow
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DOI：
10.1111/j.1447-0756.2007.00669.x
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发表时间：
2007-12-01
影响因子：
1.6
通讯作者：
Kaya, Hakan
中科院分区：
文献类型：
--
作者：
Sezik, Mekin;Ozkaya, Okan;Kaya, Hakan
目的：为了研究在腹式子宫切除术（无卵巢切除术）期间进行全输卵管切除术对某些卵巢储备参数和通过卵巢stroma.Methods血流速度测量的短期和中期后果：招募了24例患者，随机分为两组。第1组患者（n = 12）行全子宫切除术和双侧输卵管完全切除术。第2组（经典方法），部分切除输卵管，留下邻近的卵巢旁组织。术前和术后（1个月和6个月），血清促卵泡激素（FSH），促黄体生成素（LH），雌二醇值，卵巢体积估计经阴道超声，卵巢基质血流多普勒测速在早期卵泡期进行了评估。结果：两组基线资料比较，差异无统计学意义（P > 0.05）。两种技术后的平均FSH、LH、雌二醇值和卵巢体积均无变化。然而，与基线值相比，两组的平均搏动指数、阻力指数和收缩期/舒张期（S/D）比值均显著降低（第1组，分别为P = 0.027、P = 0.018和P = 0.013;第2组，分别为P = 0.01、P = 0.002和P = 0.0001）。术后平均搏动指数下降更明显（P = 0.02）在第2组（部分切除）。结论：它出现在子宫切除术中输卵管完全切除卵巢血供没有有利的影响。在生殖期行子宫切除术时，应尽可能保护卵巢血供。
Aim: To investigate the short- and medium-term consequences of performing total salpingectomy during abdominal hysterectomy (without oophorectomy) on certain ovarian reserve parameters and blood flow velocity measurements through the ovarian stroma.Methods: Twenty-four patients were recruited and randomized into two groups. Group 1 patients (n = 12) underwent total hysterectomy and complete excision of the fallopian tubes bilaterally. In group 2 (classical approach), fallopian tubes were removed partially leaving behind the neighboring paraovarian tissue. Pre- and postoperative (at 1 and 6 months) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol values, ovarian volume estimation by transvaginal ultrasound, and ovarian stromal blood flow Doppler velocimetry were assessed during the early follicular phase. Mann-Whitney U-test, Student's t-test and Freidman's test were used for comparisons.Results: Baseline data were similar across the groups (P > 0.05). Mean FSH, LH, estradiol values, and ovarian volume were unchanged after both of the techniques. However, mean pulsatility index, resistance index, and systole/diastole (S/D) ratio were significantly decreased in both groups compared to baseline values (group 1, P = 0.027, P = 0.018, and P = 0.013, respectively; group 2, P = 0.01, P = 0.002, and P = 0.0001, respectively). Postoperative decline in the mean pulsatility index was more pronounced (P = 0.02) in group 2 (partial removal).Conclusion: It appears that complete removal of fallopian tubes during hysterectomy has no advantageous effect on ovarian blood supply. It might be important to protect the ovarian blood supply as much as possible while performing hysterectomy in the reproductive period.