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Opportunistic Salpingectomy During Robotic Sacrocolpopexy: Data to Support a Widely Accepted Practice

Principal Investigator(s): View help for Principal Investigator(s) Anna Dukhovich, Montefiore Health System

Name	File Type	Size	Last Modified
Raw-Data			12/07/2022 02:24:PM
SAS-Syntax			12/07/2022 02:25:PM

Project Citation:

Dukhovich, Anna. Opportunistic Salpingectomy During Robotic Sacrocolpopexy: Data to Support a Widely Accepted Practice. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2022-12-07. https://doi.org/10.3886/E183444V1

Project Description

Summary: While surgical outcomes of prophylactic salpingectomy as an ovarian cancer risk reducing measure at the time of hysterectomy for benign indications has already been studied, data has traditionally been extrapolated to surgery for prolapse repair. After the study protocol (TSH_ObGyn_2019001, WIRB Work Order # 1-1168935-1) was reviewed and approved as exempt by the Stamford Hospital’s Institutional Review Board (IRB) of record, a retrospective chart review was performed from medical records of patients who had undergone a sacrocolpopexy for pelvic organ prolapse. Variables collected included operation duration, length of hospital stay, readmission within 31 days, estimated blood loss (EBL), number and size of incisions, as well as narcotic use during hospitalization. Additional procedures performed at the time of operation including: vaginal or laparoscopic hysterectomy, transobturator sling, anterior or posterior colporrhaphy, cystoscopy, and robotic ventral mesh rectopexy were collected as potential confounding variables. In addition, data to allow examination of pathology results of all fallopian tubes was collected to determine the proportion of pre-malignant and malignant pathology results. Statistical analyses were performed using SAS version 8. Two cohorts were created: (1) Patients who underwent adnexal surgery (bilateral salpingectomy or salpingoopherectomy) at time of the sacrocolpopexy and (2) Patients who underwent a sacrocolpopexy without adnexal surgery. Comparisons were performed with chi-square analysis for discrete variables and group t-tests for continuous level data. Narcotics administered during the immediate post-operative period until discharge was collected for each patient and converted to morphine milligram equivalents MME via multiplying the administered dose by the CDC established evidence-based conversion factor. Analysis of covariance (ANCOVA) as well as logistic regression was used to control for confounding variables, including the additional procedures patients had during their operation. An omnibus p-value of 0.05 was used to determine statistical significance for all tests. Due to the exploratory nature of this analysis, there were no corrections applied for multiple comparisons. This data can be used as a basis for researchers to build upon when assessing ovarian cancer primary prevention strategies and treatment modalities.

Scope of Project

Subject Terms: Cancer prevention; risk reduction surgery; opportunistic salpingectomy; pelvic organ prolapse; hysterectomy; ovarian cancer; sterilization

Geographic Coverage: 41° 3′ 10″ N, 73° 32′ 20″ W

Time Period(s): 1/1/2014 – 3/1/2022

Collection Date(s): 1/1/2014 – 3/1/2022

Data Type(s): clinical data; medical records; observational data

Methodology

Response Rate: Inclusion Criteria: older than age 18 and billed for the following procedures: 'SACROCOLPOPEXY ROBOT ASSISTED’ and 'LAPAROSCOPIC SACROCOLPOPEXY’ identified by de-identified billing data from our institution.

Exclusions Criteria: history of prior salpingectomies (unilateral or bilateral) or salpingoopherectomy, a history of prior gynecological malignancy, or if their records had missing data.

Sampling:

Older than age 18 years old
Billed for the following procedures:

'SACROCOLPOPEXY ROBOT ASSISTED’ & 'LAPAROSCOPIC SACROCOLPOPEXY’

Data Source: Stamford Hospital's inpatient Electronic Medical Record system.

Collection Mode(s): record abstracts

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Published Versions

V2 [2023-01-03]

V1 [2022-12-07]

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