Meta-analysis Of The Feasibility Of Prophylactic Salpingectomy

Objective:The results of recent studies have suggested that high-grade serous ovarian cancer predominantly arises within the fallopian tubes.It has been argued that prophylactic salpingectomy reduces the risk of ovarian cancer.We performed a meta-analysis to determine the impact of prophylactic salpingectomy for ovarian cancer during benign gynecologic surgery in premenopausal women to prevent ovarian cancer and to evaluate changes in ovarian endocrine function and surgical complications.Methods:We searched the Pubmed,O vid-Medline and Embase databases for all English-language articles published before 5/22/2017.Articles were screened through a multi-step process to select randomized controlled trials(RCTs),case-control studies and cohort studies.I extracted the data from studies and performed data analysis by using Stata software version 12.0.Results:1.Twelve studies met our selection criteria,including two case-control studies,one RCT and nine cohort studies.2.The Meta-analysis results based on the fixed effect model revealed a significant decrease in the risk of ovarian cancer occurrence in the patients who underwent prophylactic salpingectomy relative to the controls(OR=0.53,95%CI(0.36,0.77)).3.There were not statistically significant differences in ovarian endocrine function as measured by surrogate indicator,the change of anti-Müllerian hormone(SMD=0.12,95%CI(-0.14,0.38)).4.The operative length of hospital stay and estimated blood loss were less than when salpingectomy was additionally performed.There was no sufficient evidence to show that the effect of prophylactic salpingectomy on the change of hemoglobin is statistically significant(95%CI(-0.38,0.14)).Conclusion:1.Prophylactic salpingectomy at the time of benign gynecologic surgery may reduce the risk of ovarian cancer;2.There is no impact on the endocrine function of the ovary to perform hysterectomy with salpingectomy;3.Prophylactic salpingectomy is not associated with negative effects on increased surgical risk;4.It is feasible to perform prophylactic salpingectomy to prevent ovarian cancer in women who have no postmenopausal child-bearing requirements.