Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Goteborg, Sweden.
Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
Eur J Contracept Reprod Health Care. 2022 Jun;27(3):230-239. doi: 10.1080/13625187.2021.2010041. Epub 2021 Dec 6.
The objective of this systematic review is to evaluate current literature comparing salpingectomy for sterilisation with tubal ligation, regarding the effectiveness and safety, and assess the certainty of evidence.
PubMed, Cochrane, and Embase databases were searched. Randomised (RCT) and observational studies were included. Articles were quality assessed and data extracted by two independent authors. Certainty of evidence was assessed using GRADE.
Of 2020 articles, 17 were included. No study investigated the risk of EOC. No difference in anti-Müllerian hormone was reported in one RCT at caesarean section (CS). Two cohort studies evaluated ovarian function with surrogate measures and found no difference at caesarean section. Complications did not differ but were inconsistently reported. Laparoscopic tubal ligation was 7 min faster (95% CI 3.8-10.5). Operative time at caesarean section was dependent on the use of surgical devices. Certainty of evidence was low or very low for all estimates, indicating knowledge gaps. Reliable safety data on salpingectomy for sterilisation is lacking, and there is no effectiveness data. Presently, women cannot be properly counselled regarding salpingectomy for sterilisation.
本系统评价旨在评估比较输卵管切除术绝育与输卵管结扎术的有效性和安全性的现有文献，并评估证据的确定性。
检索了 PubMed、Cochrane 和 Embase 数据库。纳入了随机对照试验（RCT）和观察性研究。由两位独立作者进行质量评估和数据提取。使用 GRADE 评估证据确定性。
在 2020 篇文章中，有 17 篇被纳入。没有研究调查卵巢癌的风险。在一项剖宫产时的 RCT 中，抗苗勒氏管激素没有差异。两项队列研究使用替代指标评估卵巢功能，发现剖宫产时没有差异。并发症没有差异，但报告不一致。腹腔镜输卵管结扎术快 7 分钟（95%CI 3.8-10.5）。剖宫产时的手术时间取决于手术器械的使用。所有估计的证据确定性均为低或极低，表明存在知识空白。目前，缺乏输卵管切除术绝育的可靠安全性数据，也没有有效性数据。因此，目前无法对输卵管切除术绝育进行适当的咨询。
