Trends and Complications in Bilateral Salpingectomy and Hysterectomy for Benign Disease in the United States [7G

Abstract

INTRODUCTION: Recent literature has shown that bilateral salpingectomy (BS) may reduce the risk of ovarian cancer. However, little evidence exists in the United States on the rates and risks of complications associated with this procedure. We sought to examine current rates and common medical and surgical complications associated with BS with hysterectomy for benign indications in the United States. METHODS: We conducted a retrospective cohort study from the National Inpatient Sample (NIS) database. Patients undergoing hysterectomy for benign gynecological disease during 1998–2012 were identified. First, rates of BS were tested for trends over time. Second, risks of complications with BS were identified. Finally, surgical approaches for hysterectomy with BS were compared based on complications. RESULTS: During the study period 7,009,330 hysterectomies were performed for benign indications. Of these 103,966 had BS with an increase in rate from 1.0% to 5.1% between 1998 and 2012. BS procedures were associated with a significant increased risk of complications (aOR 1.063, P=.01). An abdominal approach had the greatest risk of complications (aOR 1.585, P<.001). There was no difference in risk of complications between a laparoscopic or vaginal approach (aOR 1.093, P=.244). CONCLUSION: Opportunistic BS completed with hysterectomies for benign indications are increasing; yet overall rates are still very low. There is a small statistically significant increase in risk of complications with BS as opposed to hysterectomy alone in benign cases. There is not a significantly increased risk of complications between the vaginal and laparoscopic approach.