Reply to a question regarding ovarian cancer prevention with partial salpingectomy vs complete

Dr Pitsos brings up a good point that has already been answered, at least partially, in the literature.1 Several studies, most notably Lessard-Anderson et al,2 have shown that a partial salpingectomy, or even just a distal fimbriectomy, does reduce the risk of epithelial ovarian cancer more than nonexcising procedures. Clearly, this begs the next question, which is how much of the tube needs to be removed to gain this advantage. Although it is true that Committee Opinion 7743 does recommend removal up to the uterotubal junction, the opinion acknowledges that there are interstitial portions of the tube that will not be removed. Therefore, almost any salpingectomy could be considered by some a partial salpingectomy. As a result, we were placed in a difficult position as authors by choosing where to draw the line between excisional sterilization procedure and partial salpingectomy.