Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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The rationale of opportunistic bilateral salpingectomies (OBS) during benign gynaecological and obstetric surgery: a consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG)

W.A.A. Tjalma 1 , J.J.A. Bosteels 2 , I. Cooremans 3 , S. Cosyns 4 , M. De Greve 5 , B.P. De Vree 1,6, D. Debruyne 7 , E.T. De Jonge 8 , E.J.I. Desmedt 9 , P. Dubois 10 , T. Faes 11 , M. Francx 6 , T. H amerlynck 12 , A.P. Makar 6,12 , AS Maryns 12 , I. Michiels 13 , G. Orye 14 , L. Platteeuw 7 , B. Pouseele 15 , V. Schutyser 4 , A. Segaert 16 , M. Stevens 17 , C. Tomassetti 18 , X.B. Trinh 1 , P. Tummers 12 , S.G.K. Van Calenbergh 5, P.A. van Dam 1 , B. van Herendael 19 , R. Vanspauwen 5 , I.B. Vergote 18 , J. Verguts 15 , K. Watty 20 , S. Weyers 12

1 Antwerp University Hospital – University of Antwerp, Antwerpen;
2 Imelda Hospital, Bonheiden;
3 AZ Delta campus Menen, Menen;
4 Vrije Universiteit Brussel - Universitair Ziekenhuis Brussel, Brussel;
5 AZ Turnhout, Turnhout;
6 ZNA Middelheim, Antwerpen;
7 AZ Groeninge, Kortrijk;
8 ZOL, Genk - Hasselt University, Hasselt;
9 GZA, Wilrijk;
10 KLINA, Brasschaat;
11 AZ Sint Blasius Dendermonde, Dendermonde;
12 Universitair Ziekenhuis Gent, Gent;
13 Sint-Trudo, Sint-Truiden;
14 Jessa Ziekenhuis, Hasselt;
15 OLV van Lourdes Ziekenenhuis, Waregem;
16 AZ Maria Middelares, Gent;
17 AZ Rivierenland campus Bornem, Bornem;
18 UZ Leuven, Leuven;
19 ZNA Stuivenberg, Antwerpen;
20 AZ Delta campus Roeselare, Roeselare, Belgium.

Keywords:

salpingectomy, ovarian cancer, risk-reducing, reduction, prevention, menopause, opportunistic, prophylactic, benefits, risk, safety


Published online: Oct 03 2019

Abstract

Ovarian cancer (OC), is a disease difficult to diagnose in an early stage implicating a poor prognosis. The 5-year overall survival in Belgium has not changed in the last 18 years and remains 44 %. There is no effective screening method (secondary prevention) to detect ovarian cancer at an early stage. Primary prevention of ovarian cancer came in the picture through the paradigm shift that the fallopian tube is often the origin of ovarian cancer and not the ovary itself. Opportunistic bilateral salpingectomy (OBS) during benign gynaecological and obstetric surgery might have the potential to reduce the risk of ovarian cancer by as much as 65 %. Bilateral risk-reducing salpingectomy during a benign procedure is feasible, safe, appears to have no impact on the ovarian function and seems to be cost effective. The key question is whether we should wait for a RCT or implement OBS directly in our daily practice. Guidelines regarding OBS within our societies are therefore urgently needed. Our recommendation is to inform all women without a child wish, undergoing a benign gynaecological or obstetrical surgical procedure about the pro’s and the con’s of OBS and advise a bilateral salpingectomy. Furthermore, there is an urgent need for a prospective registry of OBS. The present article is the consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG) regarding OBS.