Effects Of Hysterectomy Combined With Prophylactic Salpingectomy On Ovarian Function And Ovarian Cancer Risk: A Meta Analysis

Objective To evaluate the effect of prophylactic salpingectomy on ovarian function and ovarian cancer risk.Method According to the retrieval strategy,databases such as PubMed,Cochrane Library,Embase,Medline,Web of Science,Ovid,Academic Search Premier,CNKI,WANFANG,CBM and VIP were retrieved by computer.The search period ended in February 2019.Randomized controlled trials and clinical controlled trials comparing hysterectomy with salpingectomy(PBS group)and hysterectomy alone(non-PBS group)were included.The NOS were used to evaluate the quality of literatures.Meta analysis was performed using RevMan5.3.Study indicators:(1)ovarian function,including preoperative baseline,postoperative 3 months,postoperative 12 months of FSH,E2 levels,preoperative baseline and postoperative 3 months of AMH levels,postoperative incidence rates of perimenopause syndrome;(2)postoperative incidence rates of ovarian cancer.Result Thirty-eight references were included: 18 randomized controlled trials and 20 clinical controlled trials.Meta analysis results showed that:(1)effects on ovarian function: the FSH levels at 3 months after surgery of the PBS group was higher than that of the non-PBS group,the E2 levels at 3 months after surgery of the PBS group was lower than that of the non-PBS group(P < 0.05);between the PBS group and the non-PBS group,there was no statistically significant difference in preoperative baseline FSH and E2 and AMH levels,in the FSH and E2 levels at 12 months after surgery,in the AMH levels at 3 months after surgery,and in the incidence rates of postoperative perimenopause syndrome(P > 0.05).(2)effects on the risk of ovarian cancer: the incidence rates of postoperative ovarian cancer in the PBS group was lower than that in the non-PBS group(P < 0.05).Conclusion(1)In terms of the impact on ovarian function: current evidence suggests that prophylactic bilateral salpingectomy has little effect on ovarian function in the short term.(2)In terms of the impact on the risk of ovarian cancer: current evidence suggests that prophylactic bilateral salpingectomy has a preventive effect on ovarian cancer.However,due to the short follow-up time,the conclusion is uncertain,which needs to be further verified by improving the quality of the study and extending the follow-up time.