Effects of laparoscopic panhysterectomy with bilateral salpingectomy on ovarian function in women with postmenopausal uterine benign tumors

CHEN Gang; HE Hongxia

Abstract：Objective To investigate the effect of bilateral salpingectomy in laparoscopic panhysterectomy on women with postmenopausal uterine benign tumors. Methods 145 cases (including 19 off cases) of patients with postmenopausal uterine benign tumors who had undergone laparoscopic panhysterectomy in the Department of Gynaecology between July 2011 and July 2013 were selected as the subjects. According to whether the bilateral fallopian tubes were removed, the patients were grouped. 86 cases in the observation group received bilateral salpingectomy while 59 cases in the control group did not. Excluding off cases, there were 75 cases in the observation group and 51 cases in the control group finally. The operation time, intraoperative blood loss and length of hospital stay of the two groups were recorded. After postoperative 24 months of follow-up, the changes of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), systolic peak velocity (Vmax), end-diastolic minimal velocity (Vmin), resistance value (RI) and pulsatility indexes (PI) before operation and at 3, 12 and 24 months after operation were compared. The modified menopausal syndrome (Kupperman) score was performed. The incidence of fallopian tube lesions, pelvic masses and reoperation within 24 months of follow-up was recorded. Results 12 and 24 months after operation, E2, FSH and LH in the two groups were significantly different from those before operation (P<0.05). There was no significant difference (P>0.05) compared with those at 3 months after operation, At 12 and 24 months after operation, E2 in the observation group was significantly lower than that in the control group while FSH and LH were significantly higher (P<0.05). After operation, Vmin and Vmax of the two groups decreased significantly while PI and RI increased significantly. Compared with those before treatment, there were significant differences (P<0.05). However, compared with those before operation, 3, 12, 24 months after operation, there were no significant differences (P>0.05). The Kupperman score of the observation group at the end of follow-up was significantly higher than that of the control group (P<0.05). The incidence of fallopian tube lesions and pelvic masses in the observation group after operation (0, 5.33%) was significantly lower than in the control group (19.61%, 17.65%) (P<0.05). Conclusion Bilateral salpingectomy in laparoscopic panhysterectomy has negative effects on ovarian function by increasing postmenopausal symptoms. However, it can reduce the incidence of fallopian tube lesions and pelvic masses.