女性 BRCA1 和 BRCA2 基因变异携带者患卵巢癌的累积终生风险分别为 16-68% 和 11-30%。降低风险的双侧输卵管卵巢切除术（RRSO）是降低卵巢癌死亡率的唯一经过验证的方法。我们报告了一系列在计划产科指示的剖腹产时接受了降低风险手术的患者。这是一个病例系列，由四名携带致病性种系 BRCA1 或 BRCA2 基因改变的女性组成，她们在剖腹产时接受了 RRSO 2018 年 3 月 1 日和 2022 年 3 月 31 日。所有怀孕期间的妇女均被转诊至伦敦大学学院医院家族癌症诊所，以便在产科指示的剖腹产时考虑 RRSO。如果女性具有经证实的致病性种系改变、剖腹产后已完成生育、年龄超过 35 岁或 40 岁且分别患有 BRCA1 或 BRCA2 改变，则被认为有资格接受 RRSO。对手术时间、失血量、输血需求、住院时间、并发症和母乳喂养能力进行评估，并在可能的情况下与仅接受剖宫产的类似患者的机构方法进行比较，以确定 RRSO 是否与发病率增加相关。术后 11-59 个月联系女性以评估满意度。平均失血量为 687 mL（范围 400-1,000 mL），平均手术时间为 68 分钟，平均住院时间为 3 天，血红蛋白平均变化为 -1 g/dL。没有患者需要输血、出现内脏器官损伤、返回手术室或再次入院。两名乳房组织完整的女性中，一名成功母乳喂养，另一名则选择奶瓶喂养。剖宫产的平均同期机构失血量没有显着差异，单胎妊娠为 681 mL，双胎妊娠为 872 mL。所有四名女性都对联合手术表示高度满意。我们的结果表明，RRSO 可以在剖腹产时进行，患者满意度很高。这种方法可以提供给经过适当咨询的个人，其优点是避免了两次单独手术的需要，并有可能降低患者发病率和医疗保健成本。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 出版

The cumulative lifetime risk of ovarian cancer is 16-68% and 11-30% in female BRCA1 and BRCA2 gene alteration carriers, respectively. Risk-reducing bilateral salpingo-oophorectomy (RRSO) is the only proven way to reduce ovarian cancer mortality. We report a series of patients who underwent risk-reducing surgery at the time of planned obstetric-indicated cesarean delivery.This is a case series of four women carrying a pathogenic germline BRCA1 or BRCA2 gene alteration who underwent RRSO at the time of cesarean delivery between March 1, 2018, and March 31, 2022. All women were referred during pregnancy to the University College London Hospitals Familial Cancer Clinic for consideration of RRSO at the time of obstetric-indicated cesarean delivery. Women were considered eligible for RRSO if they had a proven pathogenic germline alteration, would have completed childbearing after the cesarean delivery, and were older than age 35 or 40 years with BRCA1 or BRCA2 alterations, respectively. Operating time, blood loss, transfusion requirements, length of hospital stay, complications, and ability to breastfeed were assessed and, where possible, compared with the institutional means for similar patients who underwent cesarean delivery only, to determine whether RRSO was associated with increased morbidity. Women were contacted 11-59 months postprocedure to assess satisfaction. The mean blood loss was 687 mL (range 400-1,000 mL), mean operating time was 68 minutes, mean length of hospital stay was 3 days, and mean change in hemoglobin was -1 g/dL. No patient required a transfusion, had internal organ damage, returned to the operating room, or was readmitted. One of two women with intact breast tissue successfully breastfed, and the other chose to bottle feed. The mean contemporaneous institutional blood loss for cesarean delivery was not significantly different at 681 mL for singleton pregnancies and 872 mL for twin pregnancies. All four women reported a high level of satisfaction with the combined procedure.Our results show that RRSO can be performed at the time of cesarean delivery with high patient satisfaction. This approach can be offered to appropriately counseled individuals, with the benefit of avoiding the need for two separate procedures, with potentially reduced patient morbidity and health care costs.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.