Safety outcomes of female sterilization by salpingectomy and tubal occlusion. 2017

Julie Westberg, and Fiona Scott, and Mitchell D Creinin
University of California, Davis; Sacramento, CA, United States.

OBJECTIVE Compare immediate and short-term complications and surgical times among women having laparoscopic salpingectomy or tubal occlusion for female sterilization. METHODS We used billing data to identify women having laparoscopic sterilization at our training institution between July 1, 2011, and June 30, 2015. We performed a retrospective chart review to extract demographic information, surgical times and complications within 30 days, including unscheduled clinic or emergency room visits. We categorized complications as immediate (prior to discharge) and short-term (within 30 days after the procedure). Surgeries including additional procedures other than IUD removal were considered mixed operations. Mixed operations and unilateral sterilization procedures were only included in safety evaluations. RESULTS The 149 procedures included 81 salpingectomies (including 18 mixed operations and 2 unilateral salpingectomies) and 68 tubal occlusions (including 8 mixed operations). All procedures involved Obstetrics and Gynecology residents. Salpingectomy and occlusion procedures had similar immediate (2.5% vs. 2.9%, p=1.0) and short-term (4.9% vs. 14.7%, p=.051) complication rates. Surgical time averaged 6 min longer for salpingectomies than occlusion procedures (44 vs. 38 min, respectively, p=.018). Average surgical times were shorter with more experienced (3rd/4th year) residents than less experienced (1st/2nd year) residents for both salpingectomy (32±18 min vs. 46±13 min, respectively, p=.124) and occlusion procedures (32±13 min vs. 41±12 min, respectively, p=.026). CONCLUSIONS Salpingectomy for female sterilization takes slightly longer to complete than tubal occlusion procedures without evidence that it increases complications. CONCLUSIONS Laparoscopic salpingectomy is a safe alternative to tubal occlusion with only a small increase in surgical time. Because salpingectomy offers higher efficacy and more ovarian cancer protection than occlusion procedures, salpingectomy should be an option offered to women seeking laparoscopic sterilization.

UI MeSH Term Description Entries
D009774 Obstetrics A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005187 Fallopian Tubes A pair of highly specialized canals extending from the UTERUS to its corresponding OVARY. They provide the means for OVUM transport from the ovaries and they are the site of the ovum's final maturation and FERTILIZATION. The fallopian tube consists of an interstitium, an isthmus, an ampulla, an infundibulum, and fimbriae. Its wall consists of three layers: serous, muscular, and an internal mucosal layer lined with both ciliated and secretory cells. Oviducts, Mammalian,Salpinges, Uterine,Salpinx, Uterine,Uterine Salpinges,Uterine Salpinx,Fallopian Tube,Uterine Tubes,Mammalian Oviduct,Mammalian Oviducts,Oviduct, Mammalian,Tube, Fallopian,Tube, Uterine,Tubes, Fallopian,Tubes, Uterine,Uterine Tube
D005260 Female Females
D006176 Gynecology A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013246 Sterilization, Tubal Procedures that render the female sterile by interrupting the flow in the FALLOPIAN TUBE. These procedures generally are surgical, and may also use chemicals or physical means. Ligation, Tubal,Tubal Ligation,Aldridge Procedure,Chemical Tubal Occlusion,Cooke Method,Cornual Coagulation,Fimbriectomy,Irving Method,Kroener Fimbriectomy,Kroener Method,Madlener Method,Nonchemical Tubal Occlusion,Occlusion, Chemical Tubal,Occlusion, Nonchemical Tubal,Pomeroy Method,Pomeroy Sterilization,Tubal Occlusion,Tubal Occlusion, Chemical,Tubal Occlusion, Nonchemical,Tubal Rings,Uchida Method,Chemical Tubal Occlusions,Coagulations, Cornual,Cornual Coagulations,Fimbriectomies,Fimbriectomy, Kroener,Ligations, Tubal,Nonchemical Tubal Occlusions,Ring, Tubal,Rings, Tubal,Sterilization, Pomeroy,Sterilizations, Tubal,Tubal Ligations,Tubal Occlusions,Tubal Occlusions, Chemical,Tubal Occlusions, Nonchemical,Tubal Ring,Tubal Sterilization,Tubal Sterilizations

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