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

Autor: Angela Sacchinelli, Roberta Venturella, Antonio Maiorana, Fulvio Zullo, Daniela Lico, Morena Rocca, Salvatore Gizzo, Michele Morelli, Annalisa Di Cello, Pietro D'Alessandro, Rita Mocciaro
Přispěvatelé: Venturella, Roberta, Morelli, Michele, Lico, Daniela, Di Cello, Annalisa, Rocca, Morena, Sacchinelli, Angela, Mocciaro, Rita, D'Alessandro, Pietro, Maiorana, Antonio, Gizzo, Salvatore, Zullo, Fulvio
Rok vydání: 2015
Předmět:
Laparoscopic surgery
Anti-Mullerian Hormone
Time Factors
Sterilization
Tubal
medicine.medical_treatment
Blood Loss
Surgical
Wide salpingectomy
Bilateral Salpingectomy
Hemoglobins
Postoperative Complications
Ovarian Follicle
Risk Factors
Surgical
Salpingectomy
Medicine
Blood Loss
ovarian cancer prevention
Ovarian Reserve
Ovarian Function Tests
ovarian reserve
prophylactic surgery
surgical outcomes
Adult
Biomarkers
Blood Flow Velocity
Female
Follicle Stimulating Hormone
Human
Hospitals
Teaching
Humans
Italy
Leiomyoma
Length of Stay
Middle Aged
Regional Blood Flow
Treatment Outcome
Uterine Neoplasms
Ovary
Medicine (all)
Reproductive Medicine
Obstetrics and Gynecology
biology
Tubal
Anti-Müllerian hormone
Hospitals
medicine.anatomical_structure
Human
medicine.medical_specialty
Mesosalpinx
surgical outcome
Ovarian reserve
business.industry
Teaching
Sterilization
Antral follicle
Surgery
biology.protein
Follicle Stimulating Hormone
business
Fallopian tube
Zdroj: Fertility and sterility. 104(5)
ISSN: 1556-5653
Popis: 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. Design Randomized, controlled trial. Setting Teaching hospital. Patient(s) One hundred eighty-six women undergoing laparoscopic surgery for uterine myoma (n = 143) or tubal surgical sterilization (n = 43). Intervention(s) 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, antimullerian 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. Main Outcome Measure(s) 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. Result(s) 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. Conclusion(s) 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. Clinical Trial Registration Number NCT02086370.
Databáze: OpenAIRE
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