Prophylactic Bilateral Salpingectomy and Laparoscopic Myomectomy

NCT ID: NCT01929148

Last Updated: 2016-11-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

154 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-08-31

Study Completion Date

2016-12-31

Brief Summary

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We already demonstrated that the addiction of PBS to Total Laparoscopic Hysterectomy (TLH) has no negative effects in term of ovarian function, evaluated by anti-Müllerian hormone (AMH), Follicle Stimulating Hormone (FSH), Antral Follicle Count (AFC), mean ovarian diameters and Peak Systolic Velocity (PSV). In addition, in our experience, no negative surgical outcomes (in terms of operative time, intraoperative blood loss, postoperative hospital stay, postoperative return to normal activity and complication rate) are related to PBS step in TLH.

Although the good statistical reliability of our retrospective data, we want to prospectively confirm our results. Moreover we aim to refine PBS safety demonstration by collecting also 3D ultrasound parameters \[AFC, ovarian volume (OV), Vascularization Index (VI), Flow Index (FI) and Vascularization Flow Index (VFI)\]. Hormonal and ultrasonographic parameters may possibly be unified into a new diagnostic algorithm (already at an advanced stage of production in UMG Department) able to estimate the ovarian function both in term of reproductive ability that in term of distance from menopause.

Detailed Description

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We will enroll the first 77 patients who will agree to implement PBS to laparoscopic myomectomy (LM) (study group), starting from September 1, 2013. Other 77 patients who will ask us to undergo LM without the addiction of PBS will constitute the control group. For each patient, ovarian reserve modification before and after surgery will be recorded as the primary outcome. Specifically, one month before and three months after laparoscopy, on day 1 to 4 of menstrual cycles serum AMH, FSH and E2 will be evaluated and a transvaginal ultrasound examination (Voluson E8 Expert or Voluson-i - GE Healthcare Ultrasound) to assess AFC, OV, VI, FI and VFI, will be carried out by the same experienced ultrasonographist responsible for the ambulatory of ovarian reserve in each Unit.

Ovarian reserve modification will be defined as the difference (expressed as Δ) between post-operative and pre-operative values of AMH, FSH, AFC, OV, VI, FI and VFI. For each surgical procedure, moreover, operative time, variation of hemoglobin level, postoperative hospital stay, postoperative return to normal activity and complication rate will be recorded as secondary outcomes.

Conditions

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Abnormal Uterine Bleeding, Unspecified

Keywords

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risk-reducing salpingectomy prophylactic bilateral salpingectomy ovarian cancer prevention ovarian reserve

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Laparoscopic myomectomy plus PBS

A Laparoscopic myomectomy plus Prophylactic bilateral salpingectomy will be performed in women which have accomplished their reproductive desire

Group Type EXPERIMENTAL

Prophylactic bilateral salpingectomy

Intervention Type PROCEDURE

Salpingectomy will be performed by coagulation and section of the tube, beginning from the very distal fimbrial end, carefully preserving the ovarian vascularization, and proceeding toward the uterine cornu

Laparoscopic myomectomy without PBS

A standard laparoscopic myomectomy without any prophylactic salpingectomy will be performed

Group Type ACTIVE_COMPARATOR

Laparoscopic myomectomy without PBS

Intervention Type PROCEDURE

Standard laparoscopic myomectomy without salpingectomy

Interventions

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Prophylactic bilateral salpingectomy

Salpingectomy will be performed by coagulation and section of the tube, beginning from the very distal fimbrial end, carefully preserving the ovarian vascularization, and proceeding toward the uterine cornu

Intervention Type PROCEDURE

Laparoscopic myomectomy without PBS

Standard laparoscopic myomectomy without salpingectomy

Intervention Type PROCEDURE

Other Intervention Names

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PBS, bilateral salpingectomy LM

Eligibility Criteria

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Inclusion Criteria

* Indication to laparoscopic myomectomy
* Accomplished reproductive desire

Exclusion Criteria

* Age older than 50 years
* family history of ovarian cancer, BRCA positive
* basal FSH value of \>20 IU/mL and/or E2 levels \>60 pg/mL
* presence of menopausal symptoms,irregular (cycle-to-cycle variation over 12 months \>20 days orpresence of any breakthrough bleeding) menstrual cycles, hormonereplacement treatment and/or hormonal contraception for the last 3 months, history of previous uterine or ovarian surgeries, and imaging suggestive of ovarian cyst or tubal pathology at transvaginal ultrasound.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University Magna Graecia

OTHER

Sponsor Role lead

Responsible Party

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Fulvio Zullo

Full Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fulvio Zullo, Md, PhD

Role: STUDY_DIRECTOR

Magna Graecia University of Catanzaro

Roberta Venturella

Role: PRINCIPAL_INVESTIGATOR

Magna Graecia University of Catanzaro

Locations

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Magna Graecia University - Azienda Ospedaliera Pugliese Ciaccio

Catanzaro, CZ, Italy

Site Status RECRUITING

Countries

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Italy

Facility Contacts

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Fulvio Zullo, MD, PhD

Role: primary

References

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Morelli M, Venturella R, Mocciaro R, Di Cello A, Rania E, Lico D, D'Alessandro P, Zullo F. Prophylactic salpingectomy in premenopausal low-risk women for ovarian cancer: primum non nocere. Gynecol Oncol. 2013 Jun;129(3):448-51. doi: 10.1016/j.ygyno.2013.03.023. Epub 2013 Apr 2.

Reference Type BACKGROUND
PMID: 23558052 (View on PubMed)

Other Identifiers

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PBS_myomectomy

Identifier Type: -

Identifier Source: org_study_id