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Acta Obstetricia et Gynecologica Scandinavica
Article . 2023 . Peer-reviewed
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Article . 2023
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First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants

Authors: Gelderblom, M.E.; Jaspers, V.; Akkermans, R.P.; Akkermans, R.P.; Slangen, B.; Oei, A.L.M.; van Ginkel, A.A.; +8 Authors

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

Abstract

AbstractIntroductionOpportunistic 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 methodsRetrospective 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.ResultsA 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.ConclusionsAlthough 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.

Country
Netherlands
Keywords

Radboudumc 18: Healthcare improvement science IQ Healthcare, opportunistic salpingectomy, Radboudumc 17: Women's cancers Health Evidence, BILATERAL SALPINGECTOMY, Radboud University Medical Center, TUBAL-STERILIZATION TECHNIQUE, Radboudumc 18: Healthcare improvement science 18-Primary and Community Care, Hysterectomy, Salpingectomy, prevention, Humans, Radboudumc 17: Women's cancers IQ Healthcare, Retrospective Studies, RISK, Gynecological Surgery, Ovarian Neoplasms, fallopian tube, REGRET, Radboudumc 18: Healthcare improvement science Primary and Community Care, Gynecology and obstetrics, Radboudumc 17: Women's cancers Gynaecology, Radboudumc 17: Women's cancers Haematology, counseling, ovarian cancer, Gynecology, SEROUS EPITHELIAL OVARIAN, RG1-991, HYSTERECTOMY, Female, performance

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Top 10%
Average
Top 10%
Green
gold