title: Prophylactic bilateral salpingectomy (PBS) to reduce ovarian cancer risk incorporated in standard premenopausal hysterectomy: complications and re-operation rate.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology and Obstetrics, Jena University Hospital, Friedrich Schiller University, Bachstrasse 18, 07743, Jena, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Vorwergk
authors.forename: M P
authors.initials: MP
authors.lastname: Radosa
authors.forename: K
authors.initials: K
authors.lastname: Nicolaus
authors.forename: N
authors.initials: N
authors.lastname: Baus
authors.forename: J
authors.initials: J
authors.lastname: Jimenez Cruz
authors.forename: M
authors.initials: M
authors.lastname: Rengsberger
authors.forename: M
authors.initials: M
authors.lastname: Gajda
authors.forename: H
authors.initials: H
authors.lastname: Diebolder
authors.forename: I B
authors.initials: IB
authors.lastname: Runnebaum
mesh_terms: D000328:Adult; D005187:Fallopian Tubes / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery*; D017697:Premenopause; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D058994:Salpingectomy