Abstract
ObjectivesTo analyze the clinicopathological characteristics of subsequent pelvic masses after hysterectomy for benign diseases, and to compare the masses following hysterectomy with or without simultaneous bilateral salpingectomy.MethodsThis study retrospectively analyzed patients undergone reoperation for pelvic mass subsequently to previous hysterectomy for benign disease from January 2012 to December 2016 in Peking Union Medical College Hospital.ResultsA total of 247 patients were enrolled in this study, of which 80.16% (n = 198) received simple hysterectomy, and 5.67% (n = 14) underwent hysterectomy with bilateral salpingectomy. The clinicopathological data of patients undergone simple hysterectomy or simultaneous bilateral salpingectomy was compared. In the former group, we found that 68.18% (n = 135) of the pelvic massed were benign, and the remaining 31.82% (n = 63) were malignant. In latter group, 57.10% (n = 8) were benign (8%) and 42.90% (n = 6) were malignant. Univariate analysis showed that the age of surgery for pelvic masses in patients undergoing hysterectomy with simultaneous bilateral salpingectomy was significantly younger than that in patients without salpingectomy (median, 44.5 vs 50 years, P < 0.0001), and the time interval between hysterectomy and onset of pelvic masses was also significantly shorter (median, 2 vs 5 years, P < 0.0001). And the probability of pelvic encapsulated effusion was significantly higher for the salpingectomy group. Multivariate analysis showed that there was no significant difference of the age of resection of pelvic mass, the time interval hysterectomy and pelvic mass onset, and the probability of pelvic encapsulated effusion between the two groups.ConclusionsThe results showed that the incidence of secondary benign pelvic masses may be reduced when hysterectomy was performed with simultaneous bilateral salpingectomy. However, there was no statistical difference in the clinical characteristics and pathological types of pelvic masses between patients received hysterectomy with or without salpingectomy.
Highlights
Hysterectomy is the most common gynecological operation and is widely accepted as the final treatment of many common gynecological diseases
This study reviewed the medical records of patients received reoperation for pelvic masses following hysterectomy due to benign diseases, compared the clinical and pathological features in patients who underwent hysterectomy with or without bilateral salpingectomy, and analyzed the possible influence of simultaneous salpingectomy on the recurrence of pelvic masses
In the group of simple hysterectomy, 166 cases (83.8%) performed total hysterectomy and 32 cases (16.2%) performed subtotal hysterectomy; while in the group of hysterectomy with simultaneous bilateral salpingectomy, all of the 14 cases were performed the procedure of total hysterectomy
Summary
Hysterectomy is the most common gynecological operation and is widely accepted as the final treatment of many common gynecological diseases. The risk of reoperation increased due to complications of hysterectomy, such as pelvic adhesion. The recurrence of pelvic mass after hysterectomy is the common reason for reoperation [1,2,3]. It had been reported that simultaneous bilateral salpingectomy during hysterectomy may reduce the incidence of ovarian serous carcinoma and some benign pelvic diseases, reducing the risk of reoperation after hysterectomy [4,5,6]. Few studies have explained whether salpingectomy affects the time of pelvic mass onset, clinical characteristics and pathological types of pelvic masses after hysterectomy in patients who have been treated again for various pelvic masses
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