Garcia C, et al. - Whether or not performance of salpingectomy compared with standard tubal ligation for sterilization at the time of cesarean delivery increases operating time or complication rates was investigated. Compared to standard tubal ligation, salpingectomy procedure time was not noted to be longer during cesarean delivery, with a mean difference of 30 seconds. Salpingectomy showed a high completion rate (95%) with no apparent increase in complications.

Methods

• At a single academic institution, researchers performed randomized controlled noninferiority trial.
• They randomized women undergoing planned cesarean delivery who desired sterilization to salpingectomy or standard tubal ligation.
• Length of time of the sterilization procedure, with the noninferiority margin set at 5 minutes, was assessed as the primary outcome.
• To achieve a power of 90% with an α of 0.05, 18 women were required to complete each intervention with a one-sided independent sample t test.

Results

• Researchers enrolled 44 women.
• Of these, 19 successfully underwent salpingectomy and 18 underwent standard tubal ligation.
• In 1 of 20 patients, salpingectomy could not be completed as a result of adhesions.
• The groups were equivalent in terms of baseline demographics.
• In this study, salpingectomy procedure time was noted to be noninferior to standard tubal ligation, with a mean difference of 0.5 minutes, with a mean sterilization procedure time of 5.6 minutes in the salpingectomy group and 6.1 minutes in the standard tubal ligation group (P <.05, one-sided 95% CI upper bound 1.8 minutes).
• No difference between cesarean delivery with salpingectomy compared with cesarean delivery with standard tubal ligation was identified in terms of median total operating time (60 vs 68 minutes, P=.34) or estimated blood loss (600 vs 700 mL, P=.09).
• Reoperation or readmission was not required for any patient in the either group.