The performance and safety of bilateral salpingectomy for ovarian cancer prevention in the United States Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

Blog Archives: Nov 2004 - present

#ovariancancers



Special items: Ovarian Cancer and Us blog best viewed in Firefox

Search This Blog

Saturday, November 05, 2016

The performance and safety of bilateral salpingectomy for ovarian cancer prevention in the United States



 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).
                               ~~~~~~~~~~~~~~~~~~~~~~~~
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 factors 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.

0 comments :

Post a Comment

Your comments?