{"title":"Effects of salpingectomy during abdominal hysterectomy on ovarian reserve: a randomized controlled trial.","authors":"Afsaneh Tehranian, Roghayeh Hassani Zangbar, Faezeh Aghajani, Mahdi Sepidarkish, Saeedeh Rafiei, Tayebe Esfidani","doi":"10.1186/s10397-017-1019-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the effect of salpingectomy on ovarian function by measuring AMH.</p><p><strong>Methods: </strong>This study was a balanced, single-center, double-blind, randomized, controlled trial in Ruin Tan Arash Hospital, Tehran, between May 2013 and November 2014. A total of 30 patients undergoing elective abdominal hysterectomy were randomized into two groups, 15 with salpingectomy and 15 without salpingectomy. The primary objective of this study was to compare mean difference of anti-Mullerian hormone (AMH) between two groups. The secondary outcomes measured were follicle-stimulating hormone (FSH), operative time, and blood loss.</p><p><strong>Results: </strong>Serum AMH levels decreased at 3 months after hysterectomy in all patients (pre AMH 1.32 ± (0.91); post AMH 1.05 ± (0.88), <i>P</i> < 0.001), the salpingectomy group (pre AMH 1.44 ± (0.94); post AMH 1.13 ± (0.86), <i>P</i> < 0.001), and no salpingectomy group (pre AMH 1.2 ± (0.9); post AMH 0.97 ± (0.92), <i>P</i> < 0.001). The rate of decline of AMH levels after surgery did not differ between the two groups (25% (17-33%) vs. 26% (15-36%), <i>P</i> = 0.23) among the women with salpingectomy versus without salpingectomy, respectively. There was no difference in the mean operative time (mean difference 0.33, 95% CI - 22.21 to 22.86, <i>P</i> < 0.92), mean blood loss (mean difference - 0.66, 95% CI - 15.8 to 14.46, <i>P</i> < 0.97), and post FSH (mean difference 0.34, 95% CI - 1.2 to 1.88, <i>P</i> < 0.65) between both groups.</p><p><strong>Conclusions: </strong>Salpingectomy with abdominal hysterectomy is a safe treatment that does not have a deleterious effect on ovarian reserve.</p><p><strong>Trial registration: </strong>Iranian Registry of Clinical Trials, IRCT2014123118866N4 (www.IRCT.ir).</p>","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-017-1019-z","citationCount":"17","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gynecological Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s10397-017-1019-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/8/17 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 17
Abstract
Background: The aim of this study was to investigate the effect of salpingectomy on ovarian function by measuring AMH.
Methods: This study was a balanced, single-center, double-blind, randomized, controlled trial in Ruin Tan Arash Hospital, Tehran, between May 2013 and November 2014. A total of 30 patients undergoing elective abdominal hysterectomy were randomized into two groups, 15 with salpingectomy and 15 without salpingectomy. The primary objective of this study was to compare mean difference of anti-Mullerian hormone (AMH) between two groups. The secondary outcomes measured were follicle-stimulating hormone (FSH), operative time, and blood loss.
Results: Serum AMH levels decreased at 3 months after hysterectomy in all patients (pre AMH 1.32 ± (0.91); post AMH 1.05 ± (0.88), P < 0.001), the salpingectomy group (pre AMH 1.44 ± (0.94); post AMH 1.13 ± (0.86), P < 0.001), and no salpingectomy group (pre AMH 1.2 ± (0.9); post AMH 0.97 ± (0.92), P < 0.001). The rate of decline of AMH levels after surgery did not differ between the two groups (25% (17-33%) vs. 26% (15-36%), P = 0.23) among the women with salpingectomy versus without salpingectomy, respectively. There was no difference in the mean operative time (mean difference 0.33, 95% CI - 22.21 to 22.86, P < 0.92), mean blood loss (mean difference - 0.66, 95% CI - 15.8 to 14.46, P < 0.97), and post FSH (mean difference 0.34, 95% CI - 1.2 to 1.88, P < 0.65) between both groups.
Conclusions: Salpingectomy with abdominal hysterectomy is a safe treatment that does not have a deleterious effect on ovarian reserve.
Trial registration: Iranian Registry of Clinical Trials, IRCT2014123118866N4 (www.IRCT.ir).
背景:本研究的目的是通过测定AMH来探讨输卵管切除术对卵巢功能的影响。方法:本研究是一项平衡、单中心、双盲、随机对照试验，于2013年5月至2014年11月在德黑兰Ruin Tan Arash医院进行。选择择期腹式子宫切除术患者30例，随机分为输卵管切除术和非输卵管切除术两组。本研究的主要目的是比较两组患者抗苗勒管激素(AMH)的平均差异。次要指标为促卵泡激素(FSH)、手术时间和出血量。结果:所有患者在子宫切除术后3个月血清AMH水平均下降(AMH术前1.32±0.91);术后AMH分别为1.05±(0.88)，P P P P = 0.23)。平均手术时间差异无统计学意义(平均差0.33,95% CI - 22.21 ~ 22.86, P P P P)结论:输卵管切除术联合腹式子宫切除术是一种安全的治疗方法，对卵巢储备没有有害影响。试验注册:伊朗临床试验注册中心，IRCT2014123118866N4 (www.IRCT.ir)。
期刊介绍：
"Gynecological Surgery", founded in 2004, is the first and premier peer-reviewed scientific journal dedicated to all aspects of research, development, and training in gynecological surgery. This field is rapidly changing in response to new developments and innovations in endoscopy, robotics, imaging and other interventional procedures. Gynecological surgery is also expanding and now encompasses all surgical interventions pertaining to women health, including oncology, urogynecology and fetal surgery. The Journal publishes Original Research, Reviews, Evidence-based Viewpoints on clinical protocols and procedures, Editorials, Perspectives, Communications and Case Reports.
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