Gizzo Salvatore, Bertocco Anna, Saccardi Carlo, Di Gangi Stefania, Litta Pietro Salvatore, D'antona Donato, Nardelli Giovanni Battista
Department of Woman and Child Health, University of Padua , Padua , Italy.
Minim Invasive Ther Allied Technol. 2014 Oct;23(5):261-70. doi: 10.3109/13645706.2014.901975. Epub 2014 Mar 28.
The aim of this review is to compare studies concerning female sterilization in order to define the most suitable approach and device for each patient considering timing, safety, cost-effectiveness, failure rate, complication rate and patient satisfaction.
A systematic literature search was conducted in electronic databases MEDLINE-EMBASE-Sciencedirect and Cochrane Library between 2000 and 2012. All original descriptions, case reports, retrospective and review articles on tubal sterilization methods have been considered. Outcome measures were effectiveness, tolerability, procedure complications and female satisfaction.
The ideal female sterilization system should be a simple, safe, highly efficient, easily learned, inexpensive, one-time procedure without negative side-effects. Nowadays, the trans-cervical approach is associated with minimal postoperative pain, allowing short hospitalization and fast resumption of daily activities. Laparoscopic and laparotomic approaches are considered second choices, since, particularly in developing countries, the transcervical hysteroscopic methods will increasingly spread within gynaecological clinical practice.
Safety issues, hospital stay, costs and surgeons' experience are important factors in decision-making of the method for female sterilization. Hysteroscopic devices should be preferred when possible. The counselling time remains a fundamental step in choice. The decision concerning method depends on the setting, the surgeon's experience, the country's economical development and the woman's preference.
本综述旨在比较有关女性绝育术的研究，以便根据时间、安全性、成本效益、失败率、并发症发生率和患者满意度，为每位患者确定最合适的方法和器械。
于2000年至2012年间在电子数据库MEDLINE-EMBASE-Sciencedirect和Cochrane图书馆进行了系统的文献检索。纳入了所有关于输卵管绝育术方法的原始描述、病例报告、回顾性和综述性文章。观察指标为有效性、耐受性、手术并发症和女性满意度。
理想的女性绝育系统应是一种简单、安全、高效、易于掌握、廉价、一次性操作且无负面副作用的方法。如今，经宫颈途径术后疼痛最小，住院时间短，能快速恢复日常活动。腹腔镜和开腹途径被视为第二选择，因为特别是在发展中国家，经宫颈宫腔镜方法将在妇科临床实践中越来越广泛地应用。
安全问题、住院时间、成本和外科医生的经验是女性绝育术方法决策中的重要因素。尽可能优先选择宫腔镜器械。咨询时间仍是选择过程中的一个基本步骤。方法的决策取决于具体情况、外科医生的经验、国家的经济发展和女性的偏好。
