Opportunistic prophylactic salpingectomy for prevention of ovarian cancer: What do national societies advise?

Ntoumanoglou-Schuiki, Angelika; Tomasch, G; Laky, R; Taumberger, N; Bjelic‐Radisic, Vesna; Tamussino, Karl

doi:10.1016/j.ejogrb.2018.03.043

Cited by 33 publications

(33 citation statements)

References 9 publications

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“…Prophylactic salpingectomy has become routine at the time of gynaecological surgery in appropriate women in many countries 20 . The present results suggest that prophylactic salpingectomy can be done in women undergoing non-gynaecological surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The recognition that high‐grade serous ovarian cancer arises in the fallopian tubes, and that salpingectomy is associated with a reduced risk of developing ovarian cancer, has led to recommendations for prophylactic salpingectomy (opportunistic or risk‐reducing salpingectomy) at the time of benign gynaecological surgery, sterilization or caesarean section. Professional gynaecological societies, beginning with the Society of Gynecologic Oncology of Canada in 2011, and including the Royal College of Obstetricians and Gynaecologists, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the American College of Obstetricians and Gynecologists and the Austrian Society of Obstetrics and Gynaecology, have issued statements to the effect that salpingectomy should be considered at the time of pelvic surgery in appropriate women. Salpingectomy at the time of gynaecological procedures requires little additional operating time, and is not associated with prolonged hospital stay, surgical complications or readmission, or long‐term sequelae.…”

Section: Introductionmentioning

confidence: 99%

“…The recognition that high-grade serous ovarian cancer arises in the fallopian tubes, and that salpingectomy is associated with a reduced risk of developing ovarian 20 . Salpingectomy at the time of gynaecological procedures requires little additional operating time, and is not associated with prolonged hospital stay, surgical complications or readmission 21,22 , or long-term sequelae.…”

Section: Introductionmentioning

confidence: 99%

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Prophylactic salpingectomy for prevention of ovarian cancer at the time of elective laparoscopic cholecystectomy

Tomasch

Lemmerer

Oswald

et al. 2020

British Journal of Surgery

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Background Most serous ovarian cancers are now understood to originate in the fallopian tubes. Removing the tubes (salpingectomy) likely reduces the risk of developing high‐grade serous ovarian cancer. Numerous gynaecological societies now recommend prophylactic (or opportunistic) salpingectomy at the time of gynaecological surgery in appropriate women, and this is widely done. Salpingectomy at the time of non‐gynaecological surgery has not been explored and may present an opportunity for primary prevention of ovarian cancer. Methods This study investigated whether prophylactic salpingectomy with the intention of reducing the risk of developing ovarian cancer would be accepted and could be accomplished at the time of elective laparoscopic cholecystectomy. Women aged at least 45 years scheduled for elective laparoscopic cholecystectomy were recruited. They were counselled and offered prophylactic bilateral salpingectomy at the time of cholecystectomy. Outcome measures were rate of accomplishment of salpingectomy, time and procedural steps needed for salpingectomy, and complications. Results A total of 105 patients were included in the study. The rate of acceptance of salpingectomy was approximately 60 per cent. Salpingectomy was performed in 98 of 105 laparoscopic cholecystectomies (93·3 per cent) and not accomplished because of poor visibility or adhesions in seven (6·7 per cent). Median additional operating time was 13 (range 4–45) min. There were no complications attributable to salpingectomy. One patient presented with ovarian cancer 28 months after prophylactic salpingectomy; histological re‐evaluation of the tubes showed a previously undetected, focal serous tubal intraepithelial carcinoma. Conclusion Prophylactic salpingectomy can be done during elective laparoscopic cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prophylactic salpingectomy for prevention of ovarian cancer at the time of elective laparoscopic cholecystectomy

Tomasch

Lemmerer

Oswald

et al. 2020

British Journal of Surgery

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“…In spite of this apparent acceptance in clinical practice there is still no consensus. Some national and international committees have issued statements with encouragement of discussing and recommending the procedure to women in the pre-surgical consultation prior to hysterectomy, while others stress the absence of evidence and call for studies in this field [16].…”

Section: Introductionmentioning

confidence: 99%

Bridging different realities - a qualitative study on patients’ experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

et al. 2020

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Background Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated. This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy. Methods A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis. Results Twenty-one Swedish-speaking women participated. They were 40–53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist. Conclusions The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.

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Section: Introductionmentioning

confidence: 99%

Bridging different realities - a qualitative study on patients experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

Collins

Lindqvist

Mogren

et al. 2020

Preprint

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Background Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated.This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy.Methods A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis. Results Twenty-one Swedish-speaking women participated. They were 40-53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist. Conclusions The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.

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Opportunistic prophylactic salpingectomy for prevention of ovarian cancer: What do national societies advise?

Cited by 33 publications

References 9 publications

Prophylactic salpingectomy for prevention of ovarian cancer at the time of elective laparoscopic cholecystectomy

Prophylactic salpingectomy for prevention of ovarian cancer at the time of elective laparoscopic cholecystectomy

Bridging different realities - a qualitative study on patients’ experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

Bridging different realities - a qualitative study on patients experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

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