Obstet Gynecol Sci.  2018 Sep;61(5):542-552. 10.5468/ogs.2018.61.5.542.

Bilateral salpingectomy to reduce the risk of ovarian/fallopian/peritoneal cancer in women at average risk: a position statement of the Korean Society of Obstetrics and Gynecology (KSOG)

• Kim M
• Kim YH
• Kim YB
• Kim J
• Kim JW
• Park MH
• Park JH
• Rhee JH
• Lim MC
• Hong JS

• KMID: 2426019
• DOI: http://doi.org/10.5468/ogs.2018.61.5.542

Abstract

Based on the current understanding of a preventive effect of bilateral salpingectomy on ovarian/fallopian/peritoneal cancers, the Korean Society of Obstetrics and Gynecology, Korean Society of Gynecologic Endocrinology, Korean Society of Gynecologic Oncology, Korean Society of Maternal Fetal Medicine, and Korean Society for Reproductive Medicine support the following recommendations:"¢ Women scheduled for hysterectomy for benign gynecologic disease should be informed that bilateral salpingectomy reduces the risk of ovarian/fallopian/peritoneal cancer, and they should be counseled regarding this procedure at the time of hysterectomy."¢ Although salpingectomy is generally considered as a safe procedure in terms of preserving ovarian reserve, there is a lack of evidences representing its long-term outcomes. Therefore, patients should be informed about the minimal potential of this procedure for decreasing ovarian reserve."¢ Prophylactic salpingectomy during vaginal hysterectomy is favorable in terms of prevention of ovarian/fallopian/peritoneal cancer, although operation-related complications minimally increase with this procedure, compared to the complications associated with vaginal hysterectomy alone. Conversion to open or laparoscopic approach from vaginal approach to perform prophylactic salpingectomy is not recommended."¢ Women who desire permanent sterilization at the time of cesarean delivery could be counseled for prophylactic salpingectomy before surgery on an individual basis.

Keyword

Fallopian tubes; Salpingectomy; Ovarian neoplasms; Hysterectomy; Prophylactic surgical procedures

MeSH Terms

Endocrinology
Fallopian Tubes
Female
Genital Diseases, Female
Gynecology*
Humans
Hysterectomy
Hysterectomy, Vaginal
Obstetrics*
Ovarian Neoplasms
Ovarian Reserve
Prophylactic Surgical Procedures
Reproductive Medicine
Salpingectomy*
Sterilization

Figure

• 

  Fig. 1 Sectioning and extensive examination the fimbriated end protocol. (A) A fallopian tube demonstrating longitudinal sectioning of the fimbria and extensive cross-sectioning of the remainder of the tube at 2–3-mm intervals and (B) preparing cross-sections of the fallopian tube.

• 

  Fig. 2 Laparoscopic salpingectomy. Fallopian tubes are resected from the fimbrial end to the uterine cornu. Careful resection is performed at the posterior margin of the fallopian tubes, while conserving the mesosalpinx.

• 

  Fig. 3 Schematic representation of salpingectomy.

• 

  Fig. 4 Salpingectomy during cesarean delivery. (A, B) The engorged vessels in the mesosalpinx and the broad ligament during pregnancy; (C) resection of the tubo-ovarian ligament and mesosalpinx as close as possible to the fallopian tube, with ligation of engorged tubal vessels; and (D) resection of the fallopian tube at the uterine cornu.

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