dr. s kapurubandara 1,2, dr. v qin 3,5, dr. d gurram 1,5, dr. a anpalagan 1, a/prof h merkur 3, 5,...
TRANSCRIPT
DR. S KAPURUBANDARA1,2, DR. V QIN3,5, DR. D GURRAM1,5 , DR. A ANPALAGAN1, A/PROF H MERKUR3, 5, A/PROF R HOGG2, 4, DR. A BRAND2, 4
1 O&G DEPARTMENT, WESTMEAD HOSPITAL2 UNIVERSITY OF SYDNEY
3 SYDNEY WEST ADVANCED PELVIC SURGERY4 GYNAEONCOLOGY DEPARTMENT, WESTMEAD HOSPITAL
5 UNIVERSITY OF WESTERN SYDNEY,
SURVEY TO ASSESS CURRENT PRACTICE AND FACTORS AFFECTING CLINICIANS’ DECISION TO PERFORM
OPPORTUNISTIC BILATERAL SALPINGECTOMY DURING GYNAECOLOGICAL SURGERY FOR BENIGN DISEASE
OVCARE – British Columbia
• Sept 2010 Media release : “ovarian cancer related deaths can be reduced by 40%”
• RRS at hysterectomy
• RRS for permanent sterilization
• Genetic testing for HG serous cancers
FOR
Ovarian Cancer
Less tubal-related
reasons for reoperation
Pelvic painImplications
on future imaging
No benefit with tubal retention
AGAINST
Insufficient evidence
Early menopause
Intra-operative
complications
Longer operative
time
Post -operative recovery
Methodology
Validated online survey to all RANZCOG fellows
ObjectiveTo assess current practice
RANZCOG statement C-25 Consideration be given and discussed with patient
Designation
VMO Staff specialist Fellow Other (please specify)
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
48%
26%
21%
5%
VMO Staff specialist
Fellow Other (please specify)
Years of clinical practice
1-5 6-10 11-15 16-20 21-25 26-30 ≥ 310%
5%
10%
15%
20%
25%23%
11%
17%
12%
8%
13%
17%
Type of specialist
Gener
alist
Gynae
colo
gist
Obste
tricia
n
Urogy
naec
olog
ist (C
U)
Gynae
onco
logi
st (.
..
CMFM
Lapa
rosc
opic
Surg
eon
CREI
COGU0%
10%
20%
30%
40%
50%
60%
70%
80%
67%
17%
1% 2%5%
0%
5%3%
1%
Do you discuss or offer opportunistic bilateral salpingectomy during gynaecological surgery for benign indications with ovarian preservation (in a low risk population)?
Which situations would you offer RRS
AH LH VH Abdo Sx Lap Sx Lap Steri TL at CS0%
20%
40%
60%
80%
100%
120%
96%
76%
28%
57%49%
42%
25%
WHY do you offer opportunistic bilateral salpingectomy - state the single most appropriate reason why.
Future directions
Further research to define protective effect and surgical outcomes
Role of registry and method of long term follow up