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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 investigate the clinical value of simultaneous removal of bilateral fallopian tubes in patients undergoing hysterectomy or subtotal hysterectomy due to benign uterine diseases through the postoperative pathological analysis of the resected fallopian tubes. Methods Retrospective analysis of gynecological department of West China Second Hospital of Sichuan University from December 2010 to December 2015 admitted due to uterine leiomyoma, adenomyosis and other benign lesions line (laparoscopic) hysterectomy or subtotal hysterectomy at the same time fallopian tubes Clinicopathological data of 1 272 cases of resection and histopathological examination results were analyzed. Results Among the 1,272 patients, 1,226 cases underwent lateral salpingo-tubal resection and 46 cases underwent unilateral tubal resection. In 334 cases, there were signs of tenderness in attachment area (26.26%) and thickening in accessory area (31.53%) in 401 cases. A total of 2 498 tubal resections were performed. There were no significant abnormalities in the appearance of 1 654 fallopian tubes (66.21%), 636 tubal bulge (25.46%), 128 tubal redness (5.12%), Eighty-six (95.52%) tubal tubal chronic tubal inflammation, 988 (39.55%) fallopian tube cysts, 80 (3.20%) normal fallopian tubes, 78 (3.12%) tubal effusion, 48 (1.92%) tubal inflammatory manifestations, 8 (0.32%) tubal mucosal epithelial dysplasia, 4 (0.26%) tubal benign tumors and 2 %) Fallopian tube cancer. In 10 cases of fallopian tube carcinoma and tubal atypical hyperplasia, 8 patients were found to have obvious chronic inflammatory changes in the contralateral fallopian tube, including 7 cases of tubal atypical hyperplasia and 1 case of fallopian tube carcinoma. Conclusions Prophylactic tubal resection can treat tubal inflammatory lesions and remove cancerous causes.