Opportunistic Salpingectomy at the Time of Benign Laparoscopic Hysterectomy: Assessment of Possible Complications and Histopathological p53-Signatures

Abstract

Introduction The aim of this study is to assess the prevalence of tubal histopathological abnormalities (serous tubal intraepithelial carcinoma STIC and p53 signatures) and the prevalence of perioperative and postoperative complications related to opportunistic laparoscopic salpingectomy in a low risk population.

Materials and Methods In this observational prospective cohort, prophylactic bilateral salpingectomy during benign laparoscopic hysterectomy was systematically performed in 100 consecutive women. Peri- and postoperative complications were registered. Duration of salpingectomy and post-salpingectomy blood loss were also measured. Histopathological and immunohistochemical analysis with anti-p53 antibody were performed on the whole fallopian tubes according to a specific and validated protocol.

Results Laparoscopic salpingectomy was always possible without any peri- or postoperative complication attributable to the salpingectomy itself. The mean duration was 428 seconds (354 – 596) and the blood loss was 9 cm³ (2 – 15). Using histopathological and immunohistochemical assessment with anti-p53 antibody on 199 fallopian tubes (99 bilateral salpingectomies and one unilateral salpingectomy because of previous salpingectomy for ectopic pregnancy), there was a prevalence of 5.52% (11/199) of p53 signatures. No STIC were observed and no associated cancer.

Conclusions Laparoscopic salpingectomy is both feasible and innocuous during benign hysterectomy. Meticulous histopathologic examination of the tubes may reveal specific abnormalities.

Zusammenfassung

Einleitung Ziel dieser Studie war es, die Häufigkeit histopathologisch nachweisbarer Eileiteranomalien (seröse tubare intraepitheliale Karzinome [STIC] und p53-Signaturen) zu ermitteln sowie die Häufigkeit von perioperativen und postoperativen Komplikationen im Zusammenhang mit opportunistischen laparoskopischen Salpingektomien in einer Niedrigrisikogruppe zu evaluieren.

Material und Methoden In einer prospektiven Kohortenstudie wurde bei 100 konsekutiven Frauen eine prophylaktische bilaterale Salpingektomie während einer geplanten laparoskopischen Hysterektomie durchgeführt. Alle peri- und postoperativen Komplikationen wurden erfasst. Die Dauer der Salpingektomie und der postoperative Blutverlust wurden ebenfalls gemessen. Die entnommenen Eileiter wurden einer histopathologischen und immunhistochemischen Analyse mit Anti-p53-Antikörper nach einem spezifischen validierten Protokoll unterzogen.

Ergebnisse Es gab keine peri- oder postoperativen Komplikationen bei der laparoskopischen Salpingektomie, die der Salpingektomie zuzuschreiben waren. Die durchschnittliche Operationsdauer für eine Salpingektomie betrug 428 Sekunden (354 – 596), und der Blutverlust betrug 9 cm³ (2 – 15). Die histopathologische und immunhistochemische Analyse mit Anti-p53-Antikörpern bei 199 Eileitern (99 bilaterale Salpingektomien und eine einseitige Salpingektomie nach früherer Salpingektomie wegen Eileiterschwangerschaft) ergab eine Häufigkeit von 5,52% (11/199) für p53-Signaturen. Es fanden sich keine STIC und keine Karzinome.

Schlussfolgerungen Die während einer gutartigen Hysterektomie durchgeführte laparoskopische Salpingektomie ist sowohl praktikabel als auch ungefährlich. Eine sorgfältige histopathologische Untersuchung der Eileiter kann spezifische Anomalien aufdecken.

Key words

opportunistic salpingectomy - prophylactic salpingectomy - ovarian cancer - p53 signature - laparoscopy - hysterectomy

Schlüsselwörter

opportunistische Salpingektomie - prophylaktische Salpingektomie - Eierstockkrebs - p53-Signatur - Laparoskopie - Hysterektomie

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