Hadas Ganer Herman1, Ohad Gluck2, Ran Keidar2, Ram Kerner2, Michal Kovo2, David Levran3, Jacob Bar2, Ron Sagiv2. 1. Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel, associated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: hadassganer@yahoo.com. 2. Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel, associated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. In Vitro Fertilization Unit, Edith Wolfson Medical Center, Holon, Israel, associated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND:Epithelial ovarian cancer is assumed to derive from the fallopian tube. Salpingectomy has been previously demonstrated to reduce the risk of ovarian cancer, and may be used as a means of sterilization. OBJECTIVE: We aimed to compare short-term ovarian reserve and operative complications in cases of salpingectomy and tubal ligation during cesarean section. STUDY DESIGN:Study patients who underwent elective cesarean section at our institution and requested sterilization were randomized to bilateral salpingectomy or tubal ligation. Prior to surgery, blood samples were obtained for antimüllerian hormone. Surgical course was noted, including overall time, complications, and postoperative hemoglobin. Repeat antimüllerian hormone samples were obtained from patients 6-8 weeks following surgery. RESULTS: In all, 46 patients were recruited for participation, of whom 33 completed a follow-up visit, and for whom repeat antimüllerian hormone levels were available. Patients in the salpingectomy group were slightly older (37.0 ± 3.9 vs 34.3 ± 4.1 years, P = .02). No differences were noted in patient parity, body mass index, or gestational age between the groups. Pregnancy and postdelivery antimüllerian hormone levels were not significantly different between the groups, with an average increase of 0.58 ± 0.98 vs 0.39 ± 0.41 ng/mL in the salpingectomy and tubal ligation groups, respectively (P = .45). Surgeries including salpingectomy were longer by an average 13 minutes (66.0 ± 20.5 vs 52.3 ± 15.8 minutes, P = .01). No difference was demonstrated between the groups regarding surgical complications and postoperative hemoglobin decrease. CONCLUSION: Sterilization by salpingectomy appears to be as safe as tubal ligation regarding operative complications and subsequent ovarian reserve. As salpingectomy offers the advantage of cancer risk reduction, it may be offered in the settings of elective preplanned surgeries.
RCT Entities:
BACKGROUND:Epithelial ovarian cancer is assumed to derive from the fallopian tube. Salpingectomy has been previously demonstrated to reduce the risk of ovarian cancer, and may be used as a means of sterilization. OBJECTIVE: We aimed to compare short-term ovarian reserve and operative complications in cases of salpingectomy and tubal ligation during cesarean section. STUDY DESIGN: Study patients who underwent elective cesarean section at our institution and requested sterilization were randomized to bilateral salpingectomy or tubal ligation. Prior to surgery, blood samples were obtained for antimüllerian hormone. Surgical course was noted, including overall time, complications, and postoperative hemoglobin. Repeat antimüllerian hormone samples were obtained from patients 6-8 weeks following surgery. RESULTS: In all, 46 patients were recruited for participation, of whom 33 completed a follow-up visit, and for whom repeat antimüllerian hormone levels were available. Patients in the salpingectomy group were slightly older (37.0 ± 3.9 vs 34.3 ± 4.1 years, P = .02). No differences were noted in patient parity, body mass index, or gestational age between the groups. Pregnancy and postdelivery antimüllerian hormone levels were not significantly different between the groups, with an average increase of 0.58 ± 0.98 vs 0.39 ± 0.41 ng/mL in the salpingectomy and tubal ligation groups, respectively (P = .45). Surgeries including salpingectomy were longer by an average 13 minutes (66.0 ± 20.5 vs 52.3 ± 15.8 minutes, P = .01). No difference was demonstrated between the groups regarding surgical complications and postoperative hemoglobin decrease. CONCLUSION: Sterilization by salpingectomy appears to be as safe as tubal ligation regarding operative complications and subsequent ovarian reserve. As salpingectomy offers the advantage of cancer risk reduction, it may be offered in the settings of elective preplanned surgeries.
Authors: Akila Subramaniam; Christina T Blanchard; Britt K Erickson; Jeff Szychowski; Charles A Leath; Joseph R Biggio; Warner K Huh Journal: Obstet Gynecol Date: 2018-07 Impact factor: 7.661
Authors: Akila Subramaniam; Brett D Einerson; Christina T Blanchard; Britt K Erickson; Jeff Szychowski; Charles A Leath; Joseph R Biggio; Warner K Huh Journal: Gynecol Oncol Date: 2018-11-23 Impact factor: 5.482
Authors: Miranda P Steenbeek; Laura A M van Lieshout; Johanna W M Aarts; Jurgen M J Piek; Sjors F P J Coppus; Leon F A G Massuger; Rosella P M G Hermens; Joanne A de Hullu Journal: J Gynecol Oncol Date: 2018-04-30 Impact factor: 4.401