Experience with opportunistic salpingectomy during vaginal hysterectomy for uterine prolapsus

E. Töz, A. Özcan
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Abstract

Objective: The aim of this study was to evaluate the trend in uptake of salpingectomy at the time of vaginal hysterectomy after the Clinical Practice Statement of Society for Gynecologic Oncology and to assess the risk of operative/postoperative complications associated with salpingectomy during vaginal hysterectomy. Material and Methods: Patients who underwent vaginal hysterectomy or vaginal hysterectomy with salpingectomy for uterine prolapsus between January 2010 and January 2018 were analysed. We divided the patients into two groups to see the change in the rate of opportunistic salpingectomy after a systemwide practice recommendation was issued. Group 1 consist of patients who were operated between 2010-2014, before recommendation of the Society of Gynecologic Oncology that favour salpingectomy and Group 2 consist of patients operated after that. Results: From January 2010 to January 2018, a total of 1224 vaginal hysterectomies were performed. A total of 808 patients under 60 years old were included in the study. There was no difference in operating time, the median estimated blood loss, intraoperative complication and postoperative complication by the performance of salpingectomy (P>0.05). When we examine the changes in the rate of salpingectomy year by year, from 2014, the salpingectomy rates increased, being 4 % in 2013, 7 % in 2015, and 8 % in 2017 onward. Conclusion: We report an increase in the rate of salpingectomy during vaginal hysterectomies from 3 % to 7.2 % after the recommendation of the Society of Gynecologic Oncology that favour salpingectomy but this increase is not as great as the increase during laparoscopic or abdominal hysterectomies.
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阴道子宫切除术中机会性输卵管切除术治疗子宫脱垂的体会
目的:本研究的目的是评估妇科肿瘤学会临床实践声明后阴道子宫切除术时输卵管切除术的趋势,并评估阴道子宫切除术中输卵管切除术相关的手术/术后并发症的风险。材料与方法:对2010年1月至2018年1月间因子宫脱垂行阴道子宫切除术或阴道子宫切除术合并输卵管切除术的患者进行分析。我们将患者分为两组,以观察在系统范围的实践建议发布后机会性输卵管切除术发生率的变化。第一组为2010-2014年间接受手术的患者,在妇科肿瘤学会推荐输卵管切除术之前,第二组为在此之后接受手术的患者。结果:2010年1月至2018年1月,共行阴道子宫切除术1224例。共有808名60岁以下的患者被纳入研究。输卵管切除术对手术时间、中位估计出血量、术中并发症及术后并发症的影响均无统计学意义(P>0.05)。当我们检查输卵管切除术率的逐年变化时,从2014年开始,输卵管切除术率上升,2013年为4%,2015年为7%,2017年为8%。结论:我们报道,在妇科肿瘤学会推荐输卵管切除术后,阴道子宫切除术中输卵管切除术的发生率从3%增加到7.2%,但这种增加不如腹腔镜或腹部子宫切除术的增加大。
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