title: Safety outcomes of female sterilization by salpingectomy and tubal occlusion.
abstract: OBJECTIVE
  Compare immediate and short-term complications and surgical times among women having laparoscopic salpingectomy or tubal occlusion for female sterilization.
  
  
  METHODS
  We used billing data to identify women having laparoscopic sterilization at our training institution between July 1, 2011, and June 30, 2015. We performed a retrospective chart review to extract demographic information, surgical times and complications within 30 days, including unscheduled clinic or emergency room visits. We categorized complications as immediate (prior to discharge) and short-term (within 30 days after the procedure). Surgeries including additional procedures other than IUD removal were considered mixed operations. Mixed operations and unilateral sterilization procedures were only included in safety evaluations.
  
  
  RESULTS
  The 149 procedures included 81 salpingectomies (including 18 mixed operations and 2 unilateral salpingectomies) and 68 tubal occlusions (including 8 mixed operations). All procedures involved Obstetrics and Gynecology residents. Salpingectomy and occlusion procedures had similar immediate (2.5% vs. 2.9%, p=1.0) and short-term (4.9% vs. 14.7%, p=.051) complication rates. Surgical time averaged 6 min longer for salpingectomies than occlusion procedures (44 vs. 38 min, respectively, p=.018). Average surgical times were shorter with more experienced (3rd/4th year) residents than less experienced (1st/2nd year) residents for both salpingectomy (32±18 min vs. 46±13 min, respectively, p=.124) and occlusion procedures (32±13 min vs. 41±12 min, respectively, p=.026).
  
  
  CONCLUSIONS
  Salpingectomy for female sterilization takes slightly longer to complete than tubal occlusion procedures without evidence that it increases complications.
  
  
  CONCLUSIONS
  Laparoscopic salpingectomy is a safe alternative to tubal occlusion with only a small increase in surgical time. Because salpingectomy offers higher efficacy and more ovarian cancer protection than occlusion procedures, salpingectomy should be an option offered to women seeking laparoscopic sterilization.
authors.affiliation: University of California, Davis; Sacramento, CA, United States.
authors.forename: Julie
authors.initials: J
authors.lastname: Westberg
authors.affiliation: University of California, Davis; Sacramento, CA, United States.
authors.forename: Fiona
authors.initials: F
authors.lastname: Scott
authors.affiliation: University of California, Davis; Sacramento, CA, United States. Electronic address: mdcreinin@ucdavis.edu.
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Creinin
mesh_terms: D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006176:Gynecology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D009774:Obstetrics; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D058994:Salpingectomy / Q000009:adverse effects*; D013246:Sterilization, Tubal / Q000009:adverse effects
keywords: Laparoscopic; Salpingectomy; Sterilization; Surgical time