title: Prophylactic salpingectomy in premenopausal low-risk women for ovarian cancer: primum non nocere.
abstract: OBJECTIVE
  The objective of this study is to compare ovarian function and surgical outcomes between patients affected by benign uterine pathologies submitted to total laparoscopic hysterectomy (TLH) plus salpingectomy and women in which standard TLH with adnexal preservation was performed.
  
  
  METHODS
  We retrospectively compared data of 79 patients who underwent TLH plus bilateral salpingectomy (group A), with those of 79 women treated by standard TLH without adnexectomy (sTLH) (group B). Ovarian reserve modification, expressed as the difference between 3 months post-operative and pre-operative values of Anti-Müllerian Hormone (AMH), Follicle Stimulating Hormone (FSH), Antral Follicle Count (AFC), mean ovarian diameters and Peak Systolic Velocity (PSV), was recorded for each patient. For each surgical procedure, operative time, variation of hemoglobin level (ΔHb), postoperative hospital stay, postoperative return to normal activity, and complication rate were recorded as secondary outcomes.
  
  
  RESULTS
  According to our post-hoc analysis, this equivalence study resulted to have a statistical power of 96.8%. Significant difference was not observed between groups with respect to ΔAMH (p=0.35), ΔFSH (p=0.15), ΔAFC (p=0.09), Δ mean ovarian diameters (p=0.57) and ΔPSV (p=0.61). In addition, secondary outcomes such as operative time (p=0.79), ΔHb (p=0.41), postoperative hospital stay (p=0.16), postoperative return to normal activity (p=0.11) and complication rate also did not show any significant difference.
  
  
  CONCLUSIONS
  The addition of bilateral salpingectomy to TLH for prevention of ovarian cancer in women who do not carry a BRCA1/2 mutations do not show negative effects on the ovarian function. In addition, no perioperative complications are related to the salpingectomy step in TLH.
authors.affiliation: Department of Obstetrics & Gynecology, Magna Graecia University-Gynecologic Oncology Unit, Tommaso Campanella Cancer Center of Germaneto, Catanzaro, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Morelli
authors.forename: Roberta
authors.initials: R
authors.lastname: Venturella
authors.forename: Rita
authors.initials: R
authors.lastname: Mocciaro
authors.forename: Annalisa
authors.initials: A
authors.lastname: Di Cello
authors.forename: Erika
authors.initials: E
authors.lastname: Rania
authors.forename: Daniela
authors.initials: D
authors.lastname: Lico
authors.forename: Pietro
authors.initials: P
authors.lastname: D'Alessandro
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
mesh_terms: D054304:Anti-Mullerian Hormone / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000517:prevention & control*; D010053:Ovary / Q000378:metabolism / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D058994:Salpingectomy / Q000379:methods*
chemical_list: D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone