Jamieson D J, Hillis S D, Duerr A, Marchbanks P A, Costello C, Peterson H B
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Obstet Gynecol. 2000 Dec;96(6):997-1002. doi: 10.1016/s0029-7844(00)01082-6.
To estimate the risk of intraoperative or postoperative complications for interval laparoscopic tubal sterilizations.
We used a prospective, multicenter cohort study of 9475 women who had interval laparoscopic tubal sterilization to calculate the rates of intraoperative or postoperative complications. The relative safety of various methods was assessed by calculating overall complication rates for each major method of tubal occlusion. Method-related complication rates also were calculated and included only complications attributable to a method of occlusion. We used logistic regression to identify independent predictors of one or more complications.
When we used a more restrictive definition of unintended major surgery, the overall rate of complications went from 1.6 to 0.9 per 100 procedures. There was one life-threatening event and there were no deaths. Complications rates for each of the four major methods of tubal occlusion ranged from 1.17 to 1.95, with no significant differences between them. When complication rates were calculated, the spring clip method had the lowest method-related complication rate (0.47 per 100 procedures), although it was not significantly different from the others. In adjusted analysis, diabetes mellitus (adjusted odds ratio [OR] 4.5; 95% confidence interval [CI] 2.3, 8.8), general anesthesia (OR 3.2; CI 1.6, 6.6), previous abdominal or pelvic surgery (OR 2.0; CI 1.4, 2.9), and obesity (OR 1.7; CI 1.2, 2.6) were independent predictors of one or more complications.
Interval laparoscopic sterilization generally is a safe procedure; serious morbidity is rare.
评估腹腔镜输卵管绝育术术中或术后并发症的风险。
我们对9475例行腹腔镜输卵管绝育术的女性进行了一项前瞻性、多中心队列研究，以计算术中或术后并发症的发生率。通过计算每种主要输卵管阻塞方法的总体并发症发生率来评估各种方法的相对安全性。还计算了与方法相关的并发症发生率，仅包括归因于阻塞方法的并发症。我们使用逻辑回归来确定一种或多种并发症的独立预测因素。
当我们对意外大手术采用更严格的定义时，并发症的总体发生率从每100例手术中的1.6例降至0.9例。发生了1起危及生命的事件，无死亡病例。四种主要输卵管阻塞方法的并发症发生率在1.17至1.95之间，它们之间无显著差异。在计算并发症发生率时，弹簧夹法的与方法相关的并发症发生率最低（每100例手术0.47例），尽管与其他方法无显著差异。在多因素分析中，糖尿病（校正比值比[OR]4.5；95%置信区间[CI]2.3，8.8）、全身麻醉（OR 3.2；CI 1.6，6.6）、既往腹部或盆腔手术（OR 2.0；CI 1.4，2.9）和肥胖（OR 1.7；CI 1.2，2.6）是一种或多种并发症的独立预测因素。
腹腔镜输卵管绝育术通常是一种安全的手术；严重并发症罕见。
