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Opportunistic bilateral salpingectomy during gynaecological surgery for benign disease: A survey of current A ustralian practice
Author(s) -
Kapurubandara Supuni,
Qin Victoria,
Gurram Divya,
Anpalagan Anbu,
Merkur Harry,
Hogg Russell,
Brand Alison
Publication year - 2015
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12402
Subject(s) - medicine , salpingectomy , hysterectomy , general surgery , gynecology , population , obstetrics , demographics , fallopian tube , serous fluid , family medicine , surgery , ectopic pregnancy , pregnancy , demography , genetics , environmental health , sociology , biology
Background Recent evidence supports the fallopian tube as the site of origin for many pelvic serous cancers ( PSC ) including epithelial ovarian cancers ( EOC ). As a result, a change in practice with opportunistic bilateral salpingectomy ( OBS ) at the time of hysterectomy has been advocated as a preventative strategy for PSC in a low‐risk population. Aims The aim of this study was to assess current clinical practice in Australia with respect to OBS during gynaecological surgery for benign indications. Materials and Methods An anonymous online survey was sent to all active Royal Australian and New Zealand College of Obstetrics and Gynaecology ( RANZCOG ) Fellows in Australia. Data regarding clinician demographics and the proportion of clinicians offering OBS were collected. Reasons for and against offering or discussing OBS were sought. A descriptive analysis was performed. Results The response rate was 26% (280/1490) with 70% of respondents offering or discussing OBS to women undergoing gynaecological surgery for benign indications, usually at the time of abdominal (96%) or laparoscopic (76%) hysterectomy. The main reason for offering or discussing OBS was current evidence to suggest the fallopian tubes as the site of origin for most EOC . Main reasons for not offering OBS were insufficient evidence to benefit the woman (36%) or being unaware of recent evidence (33%). Conclusions The survey responses indicate that OBS is frequently discussed or offered in Australia, usually at the time of hysterectomy. Given the lack of robust evidence to suggest a benefit at a population‐based level, a national registry is recommended to monitor outcomes.