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Published byDenis Nelson Modified over 9 years ago
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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, A/PROF R HOGG 2, 4, DR. A BRAND 2, 4 1 O&G DEPARTMENT, WESTMEAD HOSPITAL 2 UNIVERSITY OF SYDNEY 3 SYDNEY WEST ADVANCED PELVIC SURGERY 4 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
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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
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Based on modelling study No evidence No RCT’s No case control studies No cohort studies
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FOR Ovarian Cancer Less tubal- related reasons for reoperation Pelvic pain Implications on future imaging No benefit with tubal retention
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AGAINST Insufficient evidence Early menopause Intra- operative complications Longer operative time Post - operative recovery
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Methodology Validated online survey to all RANZCOG fellows Objective To assess current practice RANZCOG statement C-25 Consideration be given and discussed with patient
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26% response 1490 382 366
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Designation
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Primary place of practice
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Years of clinical practice
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Type of specialist
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Do you discuss or offer opportunistic bilateral salpingectomy during gynaecological surgery for benign indications with ovarian preservation (in a low risk population)?
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Which situations would you offer RRS
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WHY do you offer opportunistic bilateral salpingectomy - state the single most appropriate reason why.
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If you do not offer opportunistic bilateral salpingectomy, the single most appropriate reason why.
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Survey Summary 70% would offer and discuss RRSMost offered at AH and LH
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Future directions Further research to define protective effect and surgical outcomes Role of registry and method of long term follow up
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Thank you
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