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Ilana Cass, MD, discusses why ob/gyns should talk with their patients about salpingectomy, as well as where to focus future research.
Dr. Ilana Cass: So the data that we have right now about the length between removing the entire fallopian tube in a salpingectomy versus the comparison group, which is really the question at hand -those women who have had a tubal ligation -we have data on the impact, the beneficial impact of removing the entire fallopian in principally low-risk women. And this comes, of course, from large retrospective studies, in some cases done from registries that link everyone who had ovarian cancer to controls and looking back in time to see if those women had ever had surgery on their fallopian tubes. We’re still lacking data to show that removing the fallopian tubes definitively prevents ovarian cancer in high-risk women. And there is a very important effort under way to enroll as many women as possible in some kind of clinical trial who have these high-risk mutations with a very much higher lifetime risk of developing ovarian cancer so that we can follow them prospectively and definitively answer this question. But I think the data we have thus far from low-risk populations really does make a compelling argument that take out the entire tube, decrease the risk of ovarian cancer.
My takeaway for the ob/gyn from the literature and where we are currently is with the best data that we have in 2019, at the time of tubal sterilization it really is important to talk to your patient about the additional benefits that she may profit from in removing the entire fallopian tube. In some cases, it may be difficult to actually remove the entire fallopian tube and, specifically, I’m referring to the cases at the time of caesarean section when the blood vessels and anatomy can be very distorted and can make it a more challenging procedure. But in the context of having a conversation with the patient in planning ahead for tubal sterilization, I absolutely recommend that doctors talk to their patients about salpingectomy to remove the entire fallopian tube.