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Persistence of Fimbrial Tissue on the Ovarian Surface Following Salpingectomy

Gan, C; Chenoy, R; Chandrasekaran, D; Brockbank, E; Hollingworth, A; Vimplis, S; Lawrence, AC; ... Manchanda, R; + view all (2017) Persistence of Fimbrial Tissue on the Ovarian Surface Following Salpingectomy. American Journal of Obstetrics and Gynecology , 217 (4) 425e.1-425e.16. 10.1016/j.ajog.2017.06.004. Green open access

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Abstract

BACKGROUND: Salpingectomy is recommended as a risk-reducing strategy for epithelial tubo-ovarian cancer. The gold standard procedure is complete tubal excision. OBJECTIVE: To assess the presence of residual fimbrial/tubal tissue on ovarian surfaces following salpingectomy. DESIGN: Prospective analysis of patients undergoing salpingo-oophorectomy +/- hysterectomy for benign indications, early cervical cancer or low risk endometrial cancer at a UK National Health Service Trust. Salpingectomy +/- hysterectomy was performed initially, followed by oophorectomy within the same operation. Separately retrieved tubes and ovaries were serially sectioned and completely examined histologically. The main outcome measure was histologically identified fimbrial/ tubal tissue on ovarian surface. Chi-square/Fisher's exact tests evaluated categorical variables (SPSS-23). RESULTS: 25 consecutive cases (mean age= 54.8 years (SD=5.0), comprising 41 adnexae (9= unilateral, 16= bilateral) were analysed. 17 (68.0%), 5 (20.0%) and 3 (12.0%), procedures were performed by consultant gynaecologists, subspecialty/specialist trainees and consultant gynaecological oncologists respectively. 12/25 (48.0%) were laparoscopic and 13/25 (52.0%) involved laparotomy. 4/25 (16.0%, CI: 4.5%, 36.1%) patients or 4/41 (9.8%, CI: 2.7%, 23.1%) adnexae showed residual microscopic fimbrial tissue on the ovarian surface. Tubes/ ovaries were free of adhesions in 23 cases. Two cases had dense adnexal adhesions but neither had residual fimbrial tissue on the ovary. Residual fimbrial tissue was not significantly associated with surgical route or experience; (consultant= 3/20 (15%), trainee= 1/5 (20%), p=1.0). CONCLUSION: Residual fimbrial tissue remains on the ovary following salpingectomy in a significant proportion of cases and could impact the level of risk-reduction obtained.

Type: Article
Title: Persistence of Fimbrial Tissue on the Ovarian Surface Following Salpingectomy
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ajog.2017.06.004
Publisher version: http://doi.org/10.1016/j.ajog.2017.06.004
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: High-grade serous carcinoma, ovarian cancer, ovarian surface, prophylactic surgery, residual fimbrial tissue, salpingectomy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
URI: https://discovery.ucl.ac.uk/id/eprint/1559985
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