First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants

Abstract Introduction Opportunistic salpingectomy (OS) refers to additional removal of the fallopian tubes during abdominal surgery performed for another medical indication, as prevention for ovarian cancer. As OS has been inconsistently implemented, its clinical practice varies worldwide. To reduce...

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Main Authors: Malou E. Gelderblom, Veerle Jaspers, Reinier P. Akkermans, Brigitte Slangen, Angele L. M. Oei, Alexandra A. vanGinkel, Huy Ngo, Joanna IntHout, Rosella P. M. G. Hermens, Joanne A. deHullu, Jurgen M. J. Piek
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14507
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author Malou E. Gelderblom
Veerle Jaspers
Reinier P. Akkermans
Brigitte Slangen
Angele L. M. Oei
Alexandra A. vanGinkel
Huy Ngo
Joanna IntHout
Rosella P. M. G. Hermens
Joanne A. deHullu
Jurgen M. J. Piek
author_facet Malou E. Gelderblom
Veerle Jaspers
Reinier P. Akkermans
Brigitte Slangen
Angele L. M. Oei
Alexandra A. vanGinkel
Huy Ngo
Joanna IntHout
Rosella P. M. G. Hermens
Joanne A. deHullu
Jurgen M. J. Piek
author_sort Malou E. Gelderblom
collection DOAJ
description Abstract Introduction Opportunistic salpingectomy (OS) refers to additional removal of the fallopian tubes during abdominal surgery performed for another medical indication, as prevention for ovarian cancer. As OS has been inconsistently implemented, its clinical practice varies worldwide. To reduce this variation, insight is required into current clinical practice and its determinants. Therefore, the study aim was to determine the implementation of counseling and performance of OS between 2015 and 2018, and its patient, surgical, physician, and hospital characteristics. Material and methods Retrospective study using electronic medical records from six different Dutch hospitals: two academic, two large teaching, and two non‐teaching hospitals. Patients were considered eligible for OS if they underwent elective non‐obstetric abdominal surgery for a gynecological indication from January 2015 through December 2018. Primary outcomes were uptake of counseling and performance of OS. Multilevel multivariable logistic regression analyses were conducted to identify characteristics associated with OS. Results A total of 3214 patients underwent elective non‐obstetric abdominal surgery for a gynecological indication and were eligible for OS. Counseling on OS increased significantly from 2.9% in 2015 to 29.4% in 2018. In this period, 440 patients were counseled on OS, of which 95.9% chose OS. Performance of OS increased significantly from 6.9% in 2015 to 44.5% in 2018. Counseling for and performance of OS were more likely in patients who had surgery by laparoscopic approach, were counseled by a gynecological resident, or had more than three contact moments before surgery. Additionally, OS was less likely in patients who had vaginal surgery. Conclusions Although the uptake of OS increased from 2015 to 2018, the majority of patients who were eligible for OS were not counseled and did not undergo OS. Its clinical practice varies on patient, surgery, and physician characteristics. Therefore, an implementation strategy tailored to associated determinants is recommended.
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spelling doaj-art-cdbf370358f548ef97027ca99bc75c872025-08-20T03:30:57ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-03-01102325726910.1111/aogs.14507First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinantsMalou E. Gelderblom0Veerle Jaspers1Reinier P. Akkermans2Brigitte Slangen3Angele L. M. Oei4Alexandra A. vanGinkel5Huy Ngo6Joanna IntHout7Rosella P. M. G. Hermens8Joanne A. deHullu9Jurgen M. J. Piek10Department of Obstetrics and Gynecology, Radboud Institute for Health Sciences Radboud University Medical Center Nijmegen The NetherlandsDepartment of Obstetrics and Gynecology and Catharina Cancer Institute Catharina Hospital Eindhoven The NetherlandsRadboud Institute for Health Sciences, Department of IQ health care Radboud University Medical Center Nijmegen The NetherlandsDepartment of Obstetrics and Gynecology Maastricht University Medical Center Maastricht The NetherlandsDepartment of Obstetrics and Gynecology Bernhoven Hospital Uden The NetherlandsDepartment of Obstetrics and Gynecology Rijnstate Hospital Arnhem The NetherlandsDepartment of Obstetrics and Gynecology Elkerliek Hospital Helmond The NetherlandsDepartment for Health Evidence, Radboud Institute for Health Sciences Radboud University Medical Center Nijmegen The NetherlandsRadboud Institute for Health Sciences, Department of IQ health care Radboud University Medical Center Nijmegen The NetherlandsDepartment of Obstetrics and Gynecology, Radboud Institute for Health Sciences Radboud University Medical Center Nijmegen The NetherlandsDepartment of Obstetrics and Gynecology and Catharina Cancer Institute Catharina Hospital Eindhoven The NetherlandsAbstract Introduction Opportunistic salpingectomy (OS) refers to additional removal of the fallopian tubes during abdominal surgery performed for another medical indication, as prevention for ovarian cancer. As OS has been inconsistently implemented, its clinical practice varies worldwide. To reduce this variation, insight is required into current clinical practice and its determinants. Therefore, the study aim was to determine the implementation of counseling and performance of OS between 2015 and 2018, and its patient, surgical, physician, and hospital characteristics. Material and methods Retrospective study using electronic medical records from six different Dutch hospitals: two academic, two large teaching, and two non‐teaching hospitals. Patients were considered eligible for OS if they underwent elective non‐obstetric abdominal surgery for a gynecological indication from January 2015 through December 2018. Primary outcomes were uptake of counseling and performance of OS. Multilevel multivariable logistic regression analyses were conducted to identify characteristics associated with OS. Results A total of 3214 patients underwent elective non‐obstetric abdominal surgery for a gynecological indication and were eligible for OS. Counseling on OS increased significantly from 2.9% in 2015 to 29.4% in 2018. In this period, 440 patients were counseled on OS, of which 95.9% chose OS. Performance of OS increased significantly from 6.9% in 2015 to 44.5% in 2018. Counseling for and performance of OS were more likely in patients who had surgery by laparoscopic approach, were counseled by a gynecological resident, or had more than three contact moments before surgery. Additionally, OS was less likely in patients who had vaginal surgery. Conclusions Although the uptake of OS increased from 2015 to 2018, the majority of patients who were eligible for OS were not counseled and did not undergo OS. Its clinical practice varies on patient, surgery, and physician characteristics. Therefore, an implementation strategy tailored to associated determinants is recommended.https://doi.org/10.1111/aogs.14507counselingfallopian tubeopportunistic salpingectomyovarian cancerperformanceprevention
spellingShingle Malou E. Gelderblom
Veerle Jaspers
Reinier P. Akkermans
Brigitte Slangen
Angele L. M. Oei
Alexandra A. vanGinkel
Huy Ngo
Joanna IntHout
Rosella P. M. G. Hermens
Joanne A. deHullu
Jurgen M. J. Piek
First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants
Acta Obstetricia et Gynecologica Scandinavica
counseling
fallopian tube
opportunistic salpingectomy
ovarian cancer
performance
prevention
title First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants
title_full First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants
title_fullStr First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants
title_full_unstemmed First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants
title_short First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants
title_sort first step in implementation of opportunistic salpingectomy for prevention of ovarian cancer current care and its determinants
topic counseling
fallopian tube
opportunistic salpingectomy
ovarian cancer
performance
prevention
url https://doi.org/10.1111/aogs.14507
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