Rationale for opportunistic salpingectomy during gynecological surgery for a benign condition: A review of the available literature

Abstract

Introduction: Recent discoveries have shed light on the benefits of opportunistic salpingectomy in the prevention of ovarian cancer. However, in this time of increasing interest in the parameters of ovarian reserve, there are no national recommendations on the subject. This literature review provides an enlightened look at the rationale for performing an opportunistic salpingectomy.

Objectives: To evaluate the benefits and risks associated with opportunistic salpingectomy during surgery for a benign gynecological condition.

Material and methods: We carried out a systematic review of the literature using the Pubmed/Medline search engine and the Cochrane database.

Results: A total of 61 articles were selected from over 300 references. The protective impact against cancer, which is widely demonstrated in the literature, is proof of the benefit of this procedure. Furthermore, no increase in intraoperative morbidity has been noted. However, the clinical impact on the ovarian reserve remains uncertain (in particular the occurrence of early pre-menopausal symptoms during the perimenopausal period). Nonetheless, the socioeconomic analysis supports performing opportunistic salpingectomy.

Conclusion: Performing opportunistic salpingectomy does not appear to cause an increase in morbidity but the impact on ovarian function is uncertain. The fact that there is a proven benefit of such a procedure against cancer indicates that prior to any surgery a clear discussion should be held with the patient in which they should be fully informed.

Keywords: Complications; Hysterectomy; Opportunistic salpingectomy; Ovarian cancer.