Ovarian cancer is difficult to diagnose early and has a poor prognosis. In Korea, ovarian cancer is the 8th most common cause of cancer-related death in women. Epithelial ovarian cancer, which accounts for more than 85% of all ovarian cancers, is more aggressive than non- epithelial ovarian cancer and accounts for 90% of ovarian cancer-related deaths.
There are no effective screening tests that can detect ovarian cancer early. Removal of the ovaries and fallopian tubes, known as risk reducing salpingo-oophorectomy, is generally recommended to prevent epithelial ovarian cancer in women at high risk of getting the disease. Increased risk reducing salpingo-oophorectomy and improved pathological assessment in high-risk women allowed pathologists to detect that serous tubal intraepithelial carcinoma and invasive fallopian tube carcinoma have been found more often in patients with a genetic predisposition to EOC. The primary prevention of ovarian cancer has emerged through a paradigm shift in which fallopian tubes are often the cause of ovarian cancer rather than the ovaries themselves. Therefore, several national studies have reported that tubal resection reduces the risk of ovarian cancer by 42-77%.
Bilateral risk-reducing salpingectomy during a benign procedure is feasible, safe, does not appear to affect ovarian function. However, there have been concerns about the potential drawbacks of prophylactic bilateral salpingectomy. Some authors have suggested that tubal resection does not cause functional damage to the ovaries. However, the potential shortcomings of ovarian reserve due to decreased ovarian arterial blood flow after bilateral salpingectomy are still debatable. Thus, laparoscopic bilateral tubal resection with a different hemostatic system may affect ovarian function.
The goal of this special issue is to provide additional data and to inform all women without a child wish, undergoing a benign gynecological laparoscopic procedure about the Pro’s and the Con’s of opportunistic bilateral salpingectomy.
Prof. Heon Jong Yoo
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