title: Tubal sterilization: complications of laparoscopy and minilaparotomy.
abstract: OBJECTIVE
  To evaluate whether intra- and post-operative morbidity varies according to the method used for female sterilization.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Berne, Inselspital, Effingerstrasse 102, Berne 3010, Switzerland. huber.alexander@gmx.net
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Huber
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Dreher
authors.forename: Luigi
authors.initials: L
authors.lastname: Raio
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D009017:Morbidity; D049590:Postpartum Period; D012189:Retrospective Studies; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods*