Academic Editor: Andrea Tinelli
Background: Ovarian cancer has the highest mortality of all gynecologic
malignancies, howeverthere is no proven effective screening for ovarian cancer.
Evidence suggests that epithelial ovarian cancer begins in the fallopian tubes.
Prophylactic bilateral total salpingectomy has been shown to reduce the risk of
epithelial ovarian cancer and is now recommended to be considered at the time of
sterilization procedures. There are limited well designed clinical trials that
compare the safety and feasibility of total salpingectomy to that of traditional
partial salpingectomy for tubal sterilization in obstetrics. We thus conducted a
randomized controlled trial to assess the safety of bilateral total salpingectomy
at the time of cesarean delivery. Methods: We conducted a
non-inferiority randomized controlled trial at the Mayo Clinic, Rochester,
Minnesota. Women age 21 years and older who were undergoing cesarean delivery and
desired concomitant sterilization were enrolled between May 17, 2017 and July 16,
2018. Stratified randomization was performed based on number of previous cesarean
deliveries and their Basal Metabolic Index, into a bilateral total salpingectomy
(BTS) group and bilateral partial salpingectomy (BPS) group. All salpingectomies
were performed using clamps and suture. The primary outcome was to compare the
mean peri-operative hemoglobin change for both groups. Secondary objectives
included sterilization completion time, postoperative length of stay, estimated
blood loss, postoperative pain and adverse events. Results: Of the 111
women screened, 40 were enrolled and randomized. Of these, 38 underwent the
assigned procedure (18 BTS, 20 BPS). No difference in Mean