Huber Alexander W, Mueller Michael D, Ghezzi Fabio, Cromi Antonella, Dreher Ekkehard, Raio Luigi
Department of Obstetrics and Gynecology, University of Berne, Inselspital, Effingerstrasse 102, Berne 3010, Switzerland.
Eur J Obstet Gynecol Reprod Biol. 2007 Sep;134(1):105-9. doi: 10.1016/j.ejogrb.2006.06.016. Epub 2006 Jul 26.
To evaluate whether intra- and post-operative morbidity varies according to the method used for female sterilization.
The database of the Swiss obstetric study group was analyzed for a period of 9 years. After the exclusion of cases with extraneous factors that may have influenced the operative outcome, three groups of patients were identified: (1) interval laparoscopic sterilization unrelated to pregnancy (n=20,325); (2) postpartum laparoscopic sterilization (n=2233); (3) postpartum sterilization by minilaparotomy (n=5095). Intra-operative and post-operative complications were compared according to the surgical approach.
A total of 27,653 patients were included in the study. The proportion of major complications was higher in group 3 than in group 1 (0.39% versus 0.10%, odds ratio 4.0, 95% CI 2.15-7.44, p<0.001) but not statistically different between groups 1 (0.10%) and 2 (0.18%). Minor complications were statistically significantly more frequent in group 3 (0.82%) than in group 1 (0.26%) or group 2 (0.27%). There was no case of intra-operative or post-operative death in the study population.
When available, a laparoscopic approach should be chosen for female sterilization. After uneventful pregnancy course and delivery, it does not seem justified to delay the endoscopic sterilization to a later time.
评估女性绝育手术所采用的方法是否会使术中和术后发病率有所不同。
对瑞士产科研究组9年期间的数据库进行分析。在排除可能影响手术结果的外部因素病例后，确定了三组患者：（1）与妊娠无关的间隔期腹腔镜绝育术（n = 20325）；（2）产后腹腔镜绝育术（n = 2233）；（3）经小切口剖腹产后绝育术（n = 5095）。根据手术方式比较术中和术后并发症。
共有27653例患者纳入研究。第3组的主要并发症比例高于第1组（0.39%对0.10%，优势比4.0，95%可信区间2.15 - 7.44，p<0.001），但第1组（0.10%）和第2组（0.18%）之间无统计学差异。第3组（0.82%）的轻微并发症在统计学上明显比第1组（0.26%）或第2组（0.27%）更常见。研究人群中无术中和术后死亡病例。
女性绝育手术若可行应选择腹腔镜手术方式。在妊娠和分娩过程顺利后，将内镜绝育术推迟至以后进行似乎没有道理。
