Women whose fallopian tubes are removed during sterilisation via laparoscopy have only marginally more surgical complications than those whose tubes are cut, a study shows.
The removal, salpingectomy, is a safe procedure that can help protect against future ovarian cancer.
Ovarian cancer is a relatively rare yet serious disease with an insidious progression, lacking early symptoms.
Late detection means that the prognosis is often poor.
According to WHO, around 440,000 women in the world are diagnosed each year. In more than half of cases, the cancer appears to start in the Fallopian tubes before spreading to the ovaries.
Women who undergo sterilisation can already be offered salpingectomy. The procedure is opportunistic salpingectomy, an established practice in gynaecological surgery for pathological changes.
Until now, however, it has not been known whether the procedure entails more surgical complications, which may lead to many women opting out. The current study, published in The Lancet Regional Health – Europe, looked explicitly at surgical complications.
There is little difference between the groups.
Almost a thousand women who were due to be sterilised via laparoscopy took part in the study and were randomly assigned to receive either standard sterilisation in which the
Fallopian tubes are cut (499 women) or extended surgery with salpingectomy (473 women).
Complications of tubal surgery can include bleeding during surgery, prolonged pain, urinary tract infections, wound infections, and hernias.
Among those participants whose fallopian tubes were removed, 8.1% experienced a complication within eight weeks of the procedure, compared to 6.2% of those participants whose tubes were cut. In this context, this is classified as an accepted difference without clinical significance.
The time taken for the procedure differed somewhat. The average time was 45 minutes when the fallopian tubes were removed, compared to 29 minutes when they were cut.
The study was carried out by researchers at the University of Gothenburg and Umeå University in cooperation with the Swedish National Quality Register of Gynecological Surgery (GynOp). It has a broad base, with participants from most of Sweden’s operating gynaecological clinics.
The lead author is Annika Strandell, Associate Professor at Sahlgrenska Academy at the University of Gothenburg and Consultant Gynaecologist at Sahlgrenska University Hospital.
She said: ‘Every case of ovarian cancer we can avoid is a big win for society and for those women who would otherwise have been affected. Surgery to remove fallopian tubes during sterilisation could provide an opportunity to prevent many new cases of cancer.’
The researchers are also studying hormonal effects in women whose fallopian tubes have been removed during sterilisation, including whether menopause occurs earlier with a risk of undesired health effects.
This aspect of their research requires a more extended follow-up period, and the first results are expected within a few years.
