The Effect On Ovarian Function By Different Ways Hysterectomy Combined Salpingectomy

Ovarian cancer as a toppeddeath rategynecologic cancer, as lacks of means of early diagnosis and early treatment, so whether it is surgery or conservative treatment, the prognosis of ovarian cancer can not always achieve the expected result.At present, more and more clinical data show that tubal infection may be associated with pelvic malignancies, such as fallopian tube cancer and ovarian cancer, the theory namely "fallopian tubes is the origin of ovarian cancer." Which caused the most concern is the "liquid tumors derived from epithelial oviduct" theory. Serous carcinoma of the fallopian tube is an early serous carcinomas, which cancer cells detach, may have spread, so that the number of pelvic malignancies within the cultivation of fallopian tube cancer.Therefore, some studies show that patients undergoing hysterectomy if preventive removal of the fallopian tubes, this highly lethal and malignant tumors such us pelvic serous adenocarcinoma can be reduced.However, this surgical approach is a moot point. Because on theory that removal of the fallopian tubes will destroy arterial network between fallopian tube and ovaries, damage the integrity of the ovary blood vessels,thereby affecting ovarian function.Therefore, the present study was to investigate when prophylactic hysterectomy with bilateral salpingectomy line is a further reduction in ovarian blood supply on the basis of the original surgery, which affects ovarian reserve and reactivity, so that patients enter menopausein advance. In this experiment, to assess the ovarian response were five indicators, namely,follicle stimulating hormone(FSH), luteinizing hormone(LH), estrogen(E2),anti-Mullerian inhibitor(AMH) and inhibin B(INHB). AMH is produced by the granular cells of preantral follicles and antral follicles, therefore, it can be used to be the reaction of the total number of follicles. Also, because AMH value has a less volatile, so its value has a good stability and not be influenced by the menstrual cycle. INHB value and the number of small antral follicles was positively correlated, it can be used to react the quality and quantity of follicles. Compared with traditional hormone which assess ovarian function, it has a high sensitivity and intuitive.In addition, in the experimental operation, the surgical time, surgical,blood loss, hospital stay, postoperative perimenopausal symptoms also can be the reference index, asessing the combined effects of different surgical methods and surgical methods on postoperative patients.In this study, the change in hormone levelsafter 3 months,6 months and12 months compared to the previous in patients with surgery had a conclusion:The difference between laparoscopic surgery group and laparotomy group on indicators had no statistically significant(P> 0.05). Hysterectomy resection combined salpingectomy compared to simple hysterectomy, it will affect ovarian function and reduce the ovarian response in the short term. 10 cases of patients in tubal resection group had perimenopausal symptoms, the incidence was 20%. 13 cases of patients in reservations oviduct group had perimenopausal symptoms, the incidence was 26%. Compared two groups,the difference was not statistically significant(P> 0.05). One patient of tubal resection group had pelvic mass, the incidence is 2%. 8 patients in reserved tubal group occurred in pelvic mass, the incidence is 16%. The diffrence btween two groups was statistically significant(P <0.05).