Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Obstet Gynecol. 2021 Mar 1;137(3):514-520. doi: 10.1097/AOG.0000000000004285.
To compare operative outcomes of postpartum salpingectomy and tubal ligation after vaginal delivery.
This retrospective cohort study identified patients who underwent tubal sterilization between January 1, 2009, and December 31, 2019, at a large academic hospital, using the electronic medical record. All patients who delivered vaginally and underwent tubal sterilization during their delivery admissions were included. The primary outcome was total operative time. Secondary outcomes included estimated blood loss, perioperative complications, and readmission within 6 weeks postpartum. Patients who underwent bilateral tubal ligation were compared with those who underwent bilateral salpingectomy using Pearson's χ2 test, Fisher exact, and Student's t test.
A total of 317 eligible patients were identified. One hundred and six (94%) salpingectomies were completed using a bipolar electrocautery device. Operative time was 3 minutes shorter in the salpingectomy group, 30 minutes (interquartile range 24-38) compared with 33.5 (26-42) minutes, P=.032. Patients who underwent salpingectomy were more likely to have estimated blood loss of 5 mL or less (our institutional shorthand for minimal blood loss) than women who underwent bilateral tubal ligation (78 [69%] vs 112 [55%], P=.015). There were no significant differences in perioperative complications between the groups.
When using electrocautery, bilateral salpingectomy can be completed in the immediate postpartum period after vaginal delivery with equivalent operative times to bilateral tubal ligation.
比较阴道分娩后行输卵管切除术与输卵管结扎术的手术结果。
本回顾性队列研究使用电子病历，于 2009 年 1 月 1 日至 2019 年 12 月 31 日，在一家大型学术医院中确定行输卵管绝育术的患者。所有经阴道分娩且在分娩住院期间行输卵管绝育术的患者均被纳入研究。主要结局指标为总手术时间。次要结局指标包括估计出血量、围手术期并发症和产后 6 周内再入院。采用 Pearson χ2 检验、Fisher 确切检验和学生 t 检验比较行双侧输卵管结扎术与双侧输卵管切除术的患者。
共确定了 317 名符合条件的患者。106 例（94%）输卵管切除术采用双极电凝设备完成。输卵管切除术组的手术时间缩短了 3 分钟，为 30 分钟（四分位距 24-38），而输卵管结扎组为 33.5 分钟（26-42），P=.032。与行双侧输卵管结扎术的患者相比，行输卵管切除术的患者更可能出现估计出血量为 5 mL 或更少（本机构用于表示微量出血的简写）（78 [69%] 例 vs 112 [55%] 例，P=.015）。两组患者围手术期并发症无显著差异。
使用电灼时，经阴道分娩后即刻行双侧输卵管切除术可获得与双侧输卵管结扎术相当的手术时间。
