Falloposcopy Rap

Has

Sujets

• Médecine

Informations

• Publié par: haute-autorite-sante
• Nombre de lectures: 20
• Licence : En savoir +
  Paternité, pas d'utilisation commerciale, partage des conditions initiales à l'identique
• Langue: Français
• Poids de l'ouvrage: 6 Mo

Extrait

PROCEDURE ASSESSMENT DOSSIER:

Unilateral or bilateral gynaecological salpingoscopy [falloposcopy] by the
uterine route, with or without: biopsy, specimen
[falloposcopy],
by laparoscopy, with or without: biopsy, specimen

(GENITOURINARY SYSTEM)


Nomenclature Department - 2002 Falloposcopy
This dossier was produced by Dr. Sun Hae Lee-Robin (Project Manager, Nomenclature
Department, email: [e-mail]), under the supervision of Dr. Marie-José Moquet (Head
of the Nomenclature Department, email: [e-mail]).
Secretarial services were provided by Khadia Dia, who also organised the working group meeting,
email: [e-mail]).
The literature search was carried out by Nathalie Dunia with the help of Sylvie Lascols, under the
supervision of Rabia Bazi, Head of the Documentation Department.

ANAES / Nomenclature Department / September 2002 2 Falloposcopy
CONTENTS

SUMMARY OF DATA AND ADVICE.........................................................................................................................................3
SUPPORTIVE ARGUMENTS ........................................................................................................................................................9
I. INTRODUCTION..........................10
II. BACKGROUND .............................................................................................................................................................10
II.1 ANATOMY OF THE FALLOPIAN TUBES..................... 10
II.2 PHYSIOLOGY OF THE F................................................................................................................ 11
II.3 TUBAL DISORDERS.................................................... 11
II.4 DIAGNOSTIC METHODS FOR TUBAL DISORDERS.... 12
III. TECHNICAL DESCRIPTIO NS.................................................................................................................................13
III.1 GYNAECOLOGICAL FALLOP OSCOPY BY THE UTERINE ROUTE............ 13
III.2 SALPINGOSCOPY BY LAPAROSCOPY...................................................................................................................... 14
IV. LITERATURE SEARCH.............................................15
IV.1 INFORMATION SOURCES.......................................................................................................... 15
IV.2 SEARCH STRATEGY AND RESULTS......................... 15
V. SELECTION AND ANALYS IS OF STUDIES......16
V.1 EFFICACY OF FALLOPOSCOPY BY THE UTERINE ROUTE....................................................................................... 16
V.2 EFFICACY OF SALPINGOSCOPY BY LAPAROSCOPY................................ 20
V.3 SAFETY AND COMPLICATIONS................................. 24
VI. FRENCH AND FOREIGN NOMENCLATURES ................................................................25
VII. POSTAL SURVEY.........................................................................................25
VII.1 UNILATERAL OR BILATERAL GYNAECOLOGICAL SALPINGOSCOPY [FALLOPOSCOPY], BY THE UTERINE
ROUTE, WITH OR WITHOUT : BIOPSY, SPECIMEN............................................................................................................. 25
VII.2 U[], BY LAPAROSCOPY,
WITH OR WITHOUT : BIOPSY, SPECIMEN........................................................................................................................... 26
VIII. ADVICE OF THE WORKING GROUP.................27
VIII.1 UNILATERAL OR BILATERAL GYNAECOLOGICAL SALPINGOSCOPY [FALLOPOSCOPY], BY THE UTERINE
ROUTE, WITH OR WITHOUT : BIOPSY, SPECIMEN. ........................................................................................................... 27
VIII.2 U[], BY LAPAROSCOPY,
WITH OR WITHOUT : BIOPSY, SPECIMEN........................................................................................................................... 28
ANNEXES ............................................................................................29
ANNEX 1. METHOD USED BY THE NOMENCLATURE DEPARTMENT TO ASSESS MEDICAL AND SURGICAL
PROCEDURES....................................................................................................................................................................... 30
ANNEX II. WORKING GROUP MEMBERS...................... 32
ANNEX III. ARTICLES SELECTED. 33
ANNEX IV. ARTICLES NOT SELECTED......................................................................................................................... 35
ANNEX V. FALLOPOSCOPY SCORE.............................. 35
ANNEX VI. TYPES OF LESIONS RECORDED FALLOPOSCOPICALLY.......................................................................... 35
ANNEX VII. BROSENS AND PUTTEMANS CLASSIFICATION OF TUBAL LESIONS IDENTIFIED
SALPINGOSCOPICALLY {PUTTEMANS 1998 221} .......................................... 36
ANNEX VIII. AFS SCORE (AMERICAN FERTILITY SOCIETY) ................................................................................... 36
REFERENCES ................................................................37

SUMMARY OF DATA AND ADVICE
ANAES / Nomenclature Department / September 2002 3 Falloposcopy
ANAES / Nomenclature Department / September 2002 4 Falloposcopy


SUMMARY OF DATA USED TO EVALUATE THE PROCEDURE
“Unilateral or bilateral gynaecological salpingoscopy [Falloposcopy],
by the uterine route, with or without: biopsy, specimen”
(08.01.06.02 - JJQE001)

• Literature review
Efficacy:
The published studies (level IV - feasibility studies) show that falloposcopy is a complex
investigation, that there is no consensus as yet on method, and that it depends to a great extent
on equipment which is still being developed and refined. Insufficient data are available to
decide whether it is of any clinical benefit.
F against

• Included in the French General Nomenclature of Professional Procedures
Yes No
F does not affect the decision

• Included in foreign nomenclatures
Australia Belgium USA Quebec (not looked at)
F in favour

• Postal survey of healthcare professionals
- response level: 46/198 (23%) gynaecologists-obstetricians
- median response: 5
F undecided

• Advice of the working group
The working group felt that the inclusion of this procedure was not justified, as there are
insufficient data to decide whether it is of any clinical benefit.
Comments: the group commented that this descriptive heading was confusing, as the report
refers to two separate procedures, and proposed the following change: “Unilateral or bilateral
falloposcopy, by the uterine route”.
Fagainst

• Comments:


ANAES / Nomenclature Department / September 2002 5 Falloposcopy


1Advice on inclusion of a procedure in the CCAM based on scientific
data, consultation of foreign nomenclatures and the opinion of
healthcare professionals
after examination of the dossier by the Scientific Council
on 6 November 2002


Section: 08.01.06.02 CCAM code: JJQE001
Current CCAM descriptive heading: Unilateral or bilateral gynaecological salpingoscopy
[Falloposcopy], by the uterine route, with or without:
biopsy, specimen
Descriptive heading submitted for evaluation: Same
Descriptive heading proposed by ANAES: Unilateral or bilateral falloposcopy, by the uterine route

Against

Comments: This procedure was proposed more than 10 years ago to assess the quality of the
tubal mucosa. However, in spite of its potential benefit, there is no consensus as yet on
method, the equipment required is not yet of a high enough standard, and insufficient data are
available to decide whether it is of any clinical benefit.


Procedure in the clinical research stage

Reassess in year(s)



In favour without recommendations


In favour with recommendations*

Specific or residual indications

Conditions under which procedure is to be performed
Requires specific training in the procedure (in addition to initial training)
To be performed in a specialist centre (staff, technical facilities)
Requires prospective data collection (efficacy, safety)

Reassess in year(s)


* Comments

1 Common Classification of Medical Procedures
ANAES / Nomenclature Department / September 2002 6 Falloposcopy
SUMMARY OF DATA USED TO EVALUATE THE PROCEDURE
“Unilateral or bilateral gynaecological salpingoscopy [Falloposcopy],
by laparoscopy, with or without: biopsy, specimen”
(08.01.06.02 - JJQC001)
• Literature review
Efficacy:
The level of evidence for published studies is low (level IV), but they show that salpingoscopy
is a useful complement to gynaecological laparoscopy for assessing the quality of the distal
tubal mucosa.
F in favour

• Included in the French General Nomenclature of Professional Procedures
Yes No
F does not affect the decision

• Included in foreign nomenclatures
Australia Belgium USA Quebec (not looked at)
F