PMID- 29852159
OWN - NLM
STAT- In-Data-Review
LR  - 20180730
IS  - 1097-6868 (Electronic)
IS  - 0002-9378 (Linking)
VI  - 219
IP  - 2
DP  - 2018 Aug
TI  - Extending the safety evidence for opportunistic salpingectomy in prevention of
      ovarian cancer: a cohort study from British Columbia, Canada.
PG  - 172.e1-172.e8
LID - S0002-9378(18)30429-0 [pii]
LID - 10.1016/j.ajog.2018.05.019 [doi]
AB  - BACKGROUND: Recent evidence has suggested that the fallopian tube may often be
      the site of origin for the most common and lethal form of ovarian cancer. As a
      result, many Colleges of Obstetrics and Gynecology, including the American
      College of Obstetricians and Gynecology, are recommending surgical removal of the
      fallopian tube (bilateral salpingectomy) at the time of other gynecologic
      surgeries (particularly hysterectomy and tubal sterilization) in women at general
      population risk for ovarian cancer, collectively referred to as opportunistic
      salpingectomy. OBJECTIVE: Previous research with the use of hospital data has
      indicated good perioperative safety of opportunistic salpingectomy, but no data
      on minor complications have been presented. Herein, we examine whether women who 
      undergo opportunistic salpingectomy are at increased risk of minor complications 
      after surgery. STUDY DESIGN: We identified all women in British Columbia who
      underwent opportunistic salpingectomy between 2008 and 2014 and examined all
      physician visits in the 2 weeks after discharge from the hospital. We compared
      women who underwent opportunistic salpingectomy at hysterectomy with women who
      underwent hysterectomy alone and women who underwent opportunistic salpingectomy 
      for sterilization with women who underwent tubal ligation. We examined visits for
      surgical infection, surgical complication, orders for laboratory tests, and
      orders for imaging (x-ray, ultrasound scan, or computed tomography scan) and
      whether women who underwent opportunistic salpingectomy were more likely to fill 
      a prescription for an antibiotic or analgesic in the 2 weeks after discharge from
      the hospital. We calculated adjusted odds ratios for these outcomes, adjusting
      for other gynecologic conditions, surgical approach, and patient age. RESULTS: We
      included 49,275 women who had undergone a hysterectomy alone, a hysterectomy with
      opportunistic salpingectomy, a hysterectomy with bilateral salpingo-oophorectomy,
      a tubal ligation, or an opportunistic salpingectomy for sterilization. In women
      who had undergone opportunistic salpingectomy, there was no increased risk for
      physician visits for surgical infection, surgical complication, ordering a
      laboratory test, or ordering imaging in the 2 weeks after discharge. There was no
      increased risk of filling a prescription for an antibiotic. However, women who
      underwent opportunistic salpingectomy were at approximately 20% increased odds of
      filling a prescription for an analgesic in the 2 weeks after discharge from the
      hospital (adjusted odds ratio, 1.23; 95% confidence interval, 1.15-1.32 for
      hysterectomy with opportunistic salpingectomy; adjusted odds ratio, 1.21; 95%
      confidence interval, 1.14-1.29 for opportunistic salpingectomy for
      sterilization). CONCLUSION: We report no differences in minor complications
      between women who undergo opportunistic salpingectomy and women who undergo
      hysterectomy alone or tubal ligation, except for a slightly increased likelihood 
      of filling a prescription for analgesic medication in the immediate 2 weeks after
      discharge.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Hanley, Gillian E
AU  - Hanley GE
AD  - Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology,
      University of British Columbia, Vancouver BC, Canada. Electronic address:
      Gillian.hanley@vch.ca.
FAU - Kwon, Janice S
AU  - Kwon JS
AD  - Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology,
      University of British Columbia, Vancouver BC, Canada.
FAU - Finlayson, Sarah J
AU  - Finlayson SJ
AD  - Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology,
      University of British Columbia, Vancouver BC, Canada.
FAU - Huntsman, David G
AU  - Huntsman DG
AD  - Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology,
      University of British Columbia, Vancouver BC, Canada; Department of Pathology &
      Laboratory Medicine, University of British Columbia, Vancouver BC, Canada.
FAU - Miller, Dianne
AU  - Miller D
AD  - Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology,
      University of British Columbia, Vancouver BC, Canada.
FAU - McAlpine, Jessica N
AU  - McAlpine JN
AD  - Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology,
      University of British Columbia, Vancouver BC, Canada.
LA  - eng
PT  - Journal Article
DEP - 20180528
PL  - United States
TA  - Am J Obstet Gynecol
JT  - American journal of obstetrics and gynecology
JID - 0370476
OTO - NOTNLM
OT  - bilateral salpingectomy
OT  - hysterectomy
OT  - ovarian cancer prevention
OT  - sterilization
EDAT- 2018/06/01 06:00
MHDA- 2018/06/01 06:00
CRDT- 2018/06/01 06:00
PHST- 2018/04/05 00:00 [received]
PHST- 2018/05/17 00:00 [revised]
PHST- 2018/05/22 00:00 [accepted]
PHST- 2018/06/01 06:00 [pubmed]
PHST- 2018/06/01 06:00 [medline]
PHST- 2018/06/01 06:00 [entrez]
AID - S0002-9378(18)30429-0 [pii]
AID - 10.1016/j.ajog.2018.05.019 [doi]
PST - ppublish
SO  - Am J Obstet Gynecol. 2018 Aug;219(2):172.e1-172.e8. doi:
      10.1016/j.ajog.2018.05.019. Epub 2018 May 28.