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Original Research Gynecology| Volume 219, ISSUE 2, P172.e1-172.e8, August 2018

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Extending the safety evidence for opportunistic salpingectomy in prevention of ovarian cancer: a cohort study from British Columbia, Canada

Published:May 28, 2018DOI:https://doi.org/10.1016/j.ajog.2018.05.019
Extending the safety evidence for opportunistic salpingectomy in prevention of ovarian cancer: a cohort study from British Columbia, Canada
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      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.

      Key words

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      Article info

      Publication history

      Published online: May 28, 2018
      Accepted: May 22, 2018
      Received in revised form: May 17, 2018
      Received: April 5, 2018

      Footnotes

      Supported by the Canadian Cancer Society Research Institute and the Canadian Institutes for Health Research and by donor funds from the Vancouver General Hospital and University of British Columbia Hospital Foundation. G.E.H. is supported by the Canadian Cancer Society Research Institute Capacity Development Award in Cancer Prevention and a CIHR New Investigator Award.

      The funding sources played no role in study design, collection of data, interpretation of data, writing of the report, or decision to submit the article for publication.

      The authors report no conflict of interest.

      Cite this article as: Hanley GE, Kwon JS, Finlayson SJ, et al. Extending the safety evidence for opportunistic salpingectomy in prevention of ovarian cancer: a cohort study from British Columbia, Canada. Am J Obstet Gynecol 2018;219:172.e1-8.

      Identification

      DOI: https://doi.org/10.1016/j.ajog.2018.05.019

      Copyright

      © 2018 Elsevier Inc. All rights reserved.

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