Salpingectomy is commonly done as part of a
procedure called a salpingo-oophorectomy, where one or both ovaries, as
well as one or both Fallopian tubes, are removed in one operation (a Bilateral Salpingo-Oophorectomy (BSO) if both ovaries and Fallopian tubes are removed).
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abstract
Background
Ovarian cancer is the leading
cause of death due to gynecologic malignancy and the fifth most common
cause of cancer deaths in developed countries. Recent evidence has
indicated that the most common and lethal form of ovarian cancer
originates in the distal fallopian tube, and recommendations for
surgical removal of the fallopian tube (bilateral salpingectomy) at the
time of other gynecologic surgeries (particularly hysterectomy and tubal
sterilization) have been made, most recently by the American College of
Obstetrics & Gynecology.
Objectives
To
assess the uptake and perioperative safety of bilateral salpingectomy
at the time of hysterectomy and tubal sterilization in the United States
and to examine the f
actors associated with increased likelihood of
getting a bilateral salpingectomy.
Study Design
The
Nationwide Inpatient Sample was used to identify all women 15 years or
older without gynecologic cancer who underwent inpatient hysterectomy or
tubal sterilization, with and without bilateral salpingectomy, between
2008 and 2013. Weighted estimates of national rates of these procedures
were calculated and the number of procedures performed estimated. Safety
was assessed by examining rates of blood transfusions, perioperative
complications, post procedural infection and fever, and adjusted odds
ratios were calculated comparing hysterectomy with salpingectomy with
hysterectomy alone.
Results
We
included
425 180 women who underwent inpatient hysterectomy between 2008
and 2013 representing a national cohort of 2 036 449(95%CI 1 959374-2
113 525) women. There was an increase in the uptake of hysterectomy with
bilateral salpingectomy of 371% across the study period, with
7.7% of
all hysterectomies including bilateral salpingectomy (BS) in 2013 (15.8%
among women retaining their ovaries). There were only 1195
salpingectomies for sterilization, thus no further comparisons were
possible. In the women who had hysterectomy with bilateral
salpingectomy, there was no increased risk for blood transfusion
(aOR=0.95) post-operative complications (aOR=0.97), post-operative infections (aOR=1.26) or fevers (aOR=1.33) compared with women undergoing
hysterectomy alone. Younger age, private for-profit hospital setting,
larger hospital size, and indication for hysterectomy were all
associated with increased
likelihood of getting a hysterectomy with
bilateral salpingectomy in women retaining their ovaries.
Conclusions
Our
results suggest that hysterectomy with bilateral salpingectomy is
significantly increasing in the US and is not associated with increased
risks of postoperative complications.
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