Incidental (Prophylactic) Salpingectomy at Benign Gynecologic Surgery and Cesarean Section: a Survey of Practice in Austria

Abstract

Introduction: Most serous ovarian cancers are now thought to originate in the fallopian tubes. This has raised the issue of performing incidental salpingectomy (also called elective, opportunistic, prophylactic or risk-reducing salpingectomy) at the time of benign gynecologic surgery or cesarean section. We conducted an online survey to ascertain the policies regarding incidental salpingectomy in Austria in late 2014.

Material and Methods: All 75 departments of obstetrics and gynecology in public hospitals in Austria were surveyed for their policies regarding incidental salpingectomy at benign gynecologic surgery or cesarean section.

Results: Sixty-six of 75 surveyed departments completed the questionnaire, resulting in a response rate of 88 %. Overall, 46 of 66 (70 %) units reported offering or recommending incidental salpingectomy at benign gynecologic surgery, 12 units (18 %) did not, and eight units (12 %) did not have a consistent policy. Salpingectomy was the preferred method for surgical sterilization, including sterilization at the time of cesarean section (71 % and 64 % of units, respectively).

Conclusions: Incidental (elective, opportunistic, prophylactic, risk-reducing) salpingectomy is now widely offered at benign gynecologic surgery and cesarean section in Austria. Evidence for the role of the fallopian tubes in the origin of serous pelvic cancer has led to changes in clinical practice.

Zusammenfassung

Einleitung: Es wird inzwischen angenommen, dass die meisten serösen Ovarialkarzinome in den Eileitern entstehen. Damit stellt sich die Frage, ob eine inzidentelle (auch elektive, opportunistische, prophylaktische oder risikomindernde) Salpingektomie im Rahmen benigner gynäkologischer Eingriffe oder während einer Sectio caesarea durchgeführt werden sollte. Ende 2014 führten wir eine Online-Umfrage durch, um die diesbezügliche Praxis in Österreich zu ermitteln.

Material und Methoden: Alle 75 Abteilungen für Geburtshilfe und Gynäkologie in den öffentlichen Krankenhäusern Österreichs wurden nach ihrer Politik bezüglich der inzidentellen Salpingektomie im Rahmen benigner gynäkologischer Eingriffe oder eines Kaiserschnitts befragt.

Ergebnisse: Der Fragebogen wurde von 66 der 75 befragten Abteilungen ausgefüllt, was einer Rücklaufquote von 88 % entspricht. Insgesamt gaben 46 von 66 (70 %) Abteilungen an, dass sie eine inzidentelle Salpingektomie im Rahmen benigner gynäkologischer Eingriffe anbieten oder empfehlen. In 12 Abteilungen (18 %) wurde sie nicht angeboten, und bei 8 Abteilungen (12 %) gab es diesbezüglich keine einheitliche Politik. Die Salpingektomie ist die bevorzugte Methode der chirurgischen Sterilisation, auch bei Sterilisationen, die im Rahmen der Sectio caesarea durchgeführt werden (71 bzw. 64 % der Abteilungen).

Schlussfolgerung: Die inzidentelle (elektive, opportunistische, prophylaktische, risikomindernde) Salpingektomie im Rahmen benigner gynäkologischer Eingriffe oder eines Kaiserschnitts wird inzwischen in der Mehrzahl öffentlicher Krankenhäuser in Österreich angeboten. Der Nachweis über die Involvierung der Eileiter bei der Entstehung seröser Beckenkarzinome hat eine Änderung der klinischen Praxis bewirkt.

Key words

ovarian cancer - prophylactic salpingectomy - incidental salpingectomy - risk-reducing salpingectomy

Schlüsselwörter

Ovarialkarzinom - prophylaktische Salpingektomie - inzidentelle Salpingektomie - risikomindernde Salpingektomie

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