Prophylactic bilateral salpingectomy (PBS) to reduce ovarian cancer risk incorporated in standard premenopausal hysterectomy: complications and re-operation rate
- 1.1k Downloads
Hysterectomy for benign conditions can be combined with bilateral salpingectomy to prevent re-intervention for malignant or benign fallopian tube pathologies. The objective of this study was to evaluate the benefit of prophylactic bilateral salpingectomy (PBS) in standard hysterectomy in premenopausal women.
This retrospective cohort study included all premenopausal patients at our institution who underwent laparoscopically assisted vaginal hysterectomy (LAVH) without oophorectomy for benign pathologies between 2001 and 2007 [PBS group (LAVH + PBS), 2006–2007; non-PBS group (LAVH without PBS), 2001–2005]. Electronic and paper-based files as well as questionnaire responses were analyzed. In 2010, a survey on patients of a non-BRCA background with and without PBS was requested to complete a standardized questionnaire. Data were analyzed for differences between both subgroups regarding surgical outcome and adnexal pathologies as reported in the postoperative follow-up.
Surgical outcomes of 540 patients (PBS: 127; non-PBS: 413) revealed no difference between groups. No preneoplastic or malignant lesions were diagnosed in the fallopian tubes. Follow-up (non-PBS 92 months, PBS 55 months; p < 0.01) responses from 295 (54.6 %) patients showed a higher incidence of benign adnexal pathologies in the non-PBS group (26.9 vs. 13.9 %; p = 0.02). The rate of LAVH-related surgical re-intervention was higher in the non-PBS group (12.56 vs. 4.16 %; p = 0.04). No malignant neoplasm was reported in the cohort.
PBS did not increase the complication rate and reduced the incidence of adnexal pathologies requiring surgical re-intervention. Prospective trials should clarify the impact of PBS on cancer mortality.
KeywordsOvarian cancer Prophylactic salpingectomy Hysterectomy Risk-reducing bilateral salpingo-oophorectomy Premenopausal women
Conflict of interest
- Guldberg R, Lidegaard O et al (2013) Salpingectomy as standard at hysterectomy? A Danish cohort study, 1977–2010. BMJ Open 3(6). doi: 10.1136/bmjopen-2013-002845
- Mingels MJ, van Ham MA et al (2013) Mullerian precursor lesions in serous ovarian cancer patients: using the SEE-Fim and SEE-End protocol. Mod Pathol. doi: 10.1038/modpathol.2013.212
- Morse AN, Hammer RA, et al (2002) Does hysterectomy without adnexectomy in patients with prior tubal interruption increase the risk of subsequent hydrosalpinx? Am J Obstet Gynecol 187(6):1483–1485; discussion 1485–1486Google Scholar
- Radosa JC, Radosa MP et al (2013) Five minutes of extended assisted ventilation with an open umbilical trocar valve significantly reduces postoperative abdominal and shoulder pain in patients undergoing laparoscopic hysterectomy. Eur J Obstet Gynecol Reprod Biol 171(1):122–127CrossRefPubMedGoogle Scholar
- Statistisches Bundesamt (2011) Gesundheit. Grunddaten der Krankenhäuser. Fachserie 12:6.1.1Google Scholar
- Whiteman MK, Hillis SD et al (2008) Inpatient hysterectomy surveillance in the United States, 2000–2004. Am J Obstet Gynecol 198(1):34e31–34e37Google Scholar