在接受盆腔放疗的绝经前女性中为保护卵巢功能而进行的腹腔镜卵巢悬吊

　　LAPAROSCOPIC OVARIAN SUSPENSION FOR THE PRESERVATION OF OVARIAN FUNCTION IN PREMENOPAUSAL WOMEN RECEIVING PELVIC RADIOTHERAPY

　　A. Agrawal^1,2,3, C.K. Giede^1,2,3 

　　¹Obstetrics, Gynecology and Reproductive Sciences, University of Saskachewan, ²Royal University Hospital, ³Saskachewan Cancer Centre, Saskatoon, SK, Canada

　　Background: Transposing the ovaries out of the radiation field is an option for preserving gonadal function in patients receiving pelvic radiation. The ovarian follicles are sensitive to DNA damage from ionizing radiation. Laparoscopic ovarian suspension prior to pelvic radiotherapy is effective in the preservation of ovarian function in premenopausal women. It will have lower postoperative morbidity and will not delay time to initiate treatment in women undergoing radiation to the pelvis for various indications. Performing oophoropexy the radiation exposure to ovaries dose is reduced to 5-10%. In terms of ovarian exposure to radiation in 40 years and younger up to 1-50 cGy there is no harm, but with 500 cGy exposure up to 60% of the follicles could be damaged

　　Study methods: Prospective cohort study, it also included retrospective data from charts of patients who underwent oophoropexy from September 2005 to September 2011.

　　Results: Oophoropexy was performed in13 patients and 11 of them required pelvic radiation treatment for cervical cancer, which was initiated within 2 to 3 weeks of the procedure. One patient did not need radiation treatment. Three out of 12 patients are deceased. Only one patient required ovarian cystectomy for abdominal pain and another had right oophorectomy done at the time of surgery for recurrent disease. Two women complained of postmenopausal symptoms and one required hormonal therapy.

　　Conclusions: Ovarian transposition did not delay initiation of treatment in these women undergoing radiation to the pelvis. Our data is small and 65% of the women had ovarian function preservation.

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