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DOI: 10.1055/s-0042-1755243
Applicability, Safety, and Efficiency of Salpingectomy versus Electrocoagulation and Laparoscopic Tubal Section in Ambulatory
Aplicabilidade, segurança e eficiência da salpingectomia versus eletrocoagulação e secção tubar laparoscópica em regime de ambulatório
Abstract
Objective Female sterilization is a surgical procedure that aims women to permanently stop the use of conception. The benefits, risks and cost-effectiveness are important issues. The purpose of this study was comparing the applicability, complications and efficacy of salpingectomy versus electrocoagulation and tubal occlusion by laparoscopy in the Ambulatory Surgery Unit.
Methods We performed a retrospective and observational study that included women undergoing laparoscopic sterilization procedures at our Ambulatory Surgery Unit, during three years. Statistical analysis was performed using SPSS, applying the Fisher exact test, the Mann-Whitney test, and Linear Regression.
Results Two hundred and twenty-one laparoscopic surgical procedures were performed, including 79 (35.7%) bilateral total salpingectomies and 142 (64.3%) electrocoagulation and bilateral tubal occlusion procedures. The majority of the procedures were performed by a resident (n = 162; 73.3%), with 40% (n = 33) of salpingectomies. The surgical time, independently the type of surgeon, was significantly shorter in the tubal occlusion (42.2 vs. 52.7 min, p < 0.001). Safety and efficacy endpoints were not significantly different between the two groups, with a case of pregnancy in tubal occlusion group.
Conclusion Salpingectomy is a safe and effective alternative comparing with electrocoagulation and tubal occlusion.
Resumo
Objetivo A esterilização feminina é um procedimento cirúrgico que auxilia as mulheres na paragem permanente de utilização de métodos contraceptivos. Os objetivos desde estudo foram comparar a aplicabilidade, complicações e eficácia da salpingectomia vs. eletrocoagulação e secção tubar na esterilização feminina em regime de ambulatório.
Métodos Realizou-se um estudo retrospectivo e observacional que incluiu mulheres submetidas a procedimentos de esterilização por laparoscopia no Serviço de Cirurgia de Ambulatório da ULSAM, durante três anos. A análise estatística foi realizada com recurso ao SPSS, aplicando o teste exato de Fisher, o teste de Mann-Whitney e Regressão Linear.
Resultados Foram realizados 221 procedimentos cirúrgicos por laparoscopia, incluindo 79 (35,7%) salpingectomias totais bilaterais e 142 (64,3%) procedimentos por eletrocoagulação e secção tubar bilateral. A maioria dos procedimentos foram realizados por um interno de formação específica (n = 162; 73,3%), com 40% (n = 33) de salpingectomias. O tempo operatório foi significativamente inferior no grupo da eletrocoagulação (42,2 vs. 52,7 min, p < 0,001). Em relação à segurança e à eficácia não se observaram diferenças estatisticamente significativas entre os dois grupos, com um caso de gravidez após eletrocoagulação e secção tubar.
Conclusão A salpingectomia é uma alternativa segura e com alta taxa de eficácia quando comparada com eletrocoagulação e secção tubar.
Publication History
Received: 09 February 2022
Accepted: 28 April 2022
Article published online:
29 August 2022
© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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