Wide excision of soft tissues adjacent to the ovary and fallopian tube does not impair the ovarian reserve in women undergoing prophylactic bilateral salpingectomy: results from a randomized, controlled trial.
OBJECTIVE
To study the effects of the wide excision of soft tissues adjacent to the ovary and fallopian tube on ovarian function and surgical outcomes in women undergoing laparoscopic bilateral prophylactic salpingectomy.


METHODS
Randomized, controlled trial.


METHODS
Teaching hospital.


METHODS
One hundred eighty-six women undergoing laparoscopic surgery for uterine myoma (n = 143) or tubal surgical sterilization (n = 43).


METHODS
Patients were randomly divided into two groups. In group A (n = 91), standard salpingectomy was performed. In group B (n = 95), the mesosalpinx was removed within the tubes. Prior to and 3 months after surgery, antimüllerian hormone (AMH), FSH, three-dimensional antral follicle count (AFC), vascular index (VI), flow index (FI), vascular-flow index (VFI), and OvAge were recorded for each patient.


METHODS
Ovarian reserve modification (Δ) before and after surgery was assessed as the primary outcome. Operative time, variation of the hemoglobin level (ΔHb), postoperative hospital stay, postoperative return to normal activity, and complication rate were assessed as secondary outcomes.


RESULTS
No significant difference was observed between groups for ΔAMH, ΔFSH, ΔAFC, ΔVI, ΔFI, ΔVFI, and ΔOvAge. Moreover, the groups were similar for operative time, ΔHb, postoperative hospital stay, postoperative return to normal activity, and complication rate.


CONCLUSIONS
Even when the surgical excision includes the removal of the mesosalpinx, salpingectomy does not damage the ovarian reserve. Moreover, wide salpingectomy with excision of the mesosalpinx did not alter blood loss, hospitalization stay, or return to normal activities.


BACKGROUND
NCT02086370.
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy. Electronic address: rovefa@libero.it.
Roberta
R
Venturella
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy; Oncologic Center Tommaso Campanella, Catanzaro, Italy.
Michele
M
Morelli
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy.
Daniela
D
Lico
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy.
Annalisa
A
Di Cello
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy.
Morena
M
Rocca
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy.
Angela
A
Sacchinelli
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy.
Rita
R
Mocciaro
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy.
Pietro
P
D'Alessandro
Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy.
Antonio
A
Maiorana
Department of Woman and Child Health, University of Padua, Padua, Italy.
Salvatore
S
Gizzo
Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy; Oncologic Center Tommaso Campanella, Catanzaro, Italy.
Fulvio
F
Zullo
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D016063:Blood Loss, Surgical; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006784:Hospitals, Teaching; D006801:Humans; D007558:Italy; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D006080:Ovarian Follicle; D010050:Ovarian Function Tests; D065851:Ovarian Reserve; D010053:Ovary / Q000098:blood supply / Q000166:cytology / Q000378:metabolism; D011183:Postoperative Complications / Q000209:etiology; D012039:Regional Blood Flow; D012307:Risk Factors; D058994:Salpingectomy / Q000009:adverse effects / Q000379:methods*; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*
D015415:Biomarkers; D043373:Follicle Stimulating Hormone, Human; D006454:Hemoglobins; D054304:Anti-Mullerian Hormone
Wide salpingectomy; ovarian cancer prevention; ovarian reserve; prophylactic surgery; surgical outcomes