Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis

Objectives: Salpingectomy and tubal ligation are commonly performed for permanent contraception in women. Salpingectomy has been suggested to reduce the risk of ovarian cancer, but its comparative operative and perioperative risks have not been well established. The objective of this study is to com...

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Main Authors: Vaishnavi J. Patel, Devki Patel, Kimberly Toumazos, Young Son, Komal Sharma, Virgil Kevin DeMario, Shelby Boock, Grace Lara, Alexandra McQuillen, Brianna Clark
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2025-06-01
Series:Laparoscopic, Endoscopic and Robotic Surgery
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Online Access:http://www.sciencedirect.com/science/article/pii/S246890092500026X
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author Vaishnavi J. Patel
Devki Patel
Kimberly Toumazos
Young Son
Komal Sharma
Virgil Kevin DeMario
Shelby Boock
Grace Lara
Alexandra McQuillen
Brianna Clark
author_facet Vaishnavi J. Patel
Devki Patel
Kimberly Toumazos
Young Son
Komal Sharma
Virgil Kevin DeMario
Shelby Boock
Grace Lara
Alexandra McQuillen
Brianna Clark
author_sort Vaishnavi J. Patel
collection DOAJ
description Objectives: Salpingectomy and tubal ligation are commonly performed for permanent contraception in women. Salpingectomy has been suggested to reduce the risk of ovarian cancer, but its comparative operative and perioperative risks have not been well established. The objective of this study is to compare the peri- and postoperative complications of laparoscopic tubal ligation with those of salpingectomy for permanent contraception. Methods: A retrospective review of 49,445 patients who underwent laparoscopic salpingectomy or tubal ligation for permanent contraception between 2017 and 2021 was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program database. Statistical analysis involved t test, chi-square test, and logistic regression analysis with the use of the random forest algorithm. The primary outcomes were perioperative and postoperative complications. Results: Of the total cohort, 45,307 (91.6%) underwent laparoscopic salpingectomy, and 4138 (8.4%) received laparoscopic tubal ligation. There were significant differences between the salpingectomy and tubal ligation groups with respect to several demographic characteristics, including age, BMI, minority status, and variations in past medical history. These demographic characteristics were controlled for in the multivariate regression analysis. Salpingectomy had a higher rate of operative and postoperative complications than did tubal ligation (OR = 1.78, 95% CI: 1.46–2.20, p < 0.001). Salpingectomy was associated with a greater risk of longer operation time (OR = 2.03, 95% CI: 2.02–2.04, p < 0.001), longer hospital stay (OR = 5.26, 95% CI: 4.57–6.09, p < 0.001), increased readmission (OR = 3.15, 95% CI: 1.92–5.65, p < 0.001), and increased unplanned reoperation (OR = 2.42, 95% CI: 1.32–5.12, p = 0.010). In addition, the occurrence rates of organ space surgical site infection (OR = 2.68, 95% CI: 1.21–7.59, p = 0.032) and sepsis (OR = 3.93, 95% CI: 1.48–16.02, p = 0.020) were significantly greater in the salpingectomy group than in the tubal ligation group. Conclusions: Laparoscopic tubal ligation and salpingectomy are both safe and effective procedures for permanent contraception; however, salpingectomy is more likely to be associated with peri- and postoperative complications. These findings may help guide clinical decision-making when selecting the optimal permanent contraception method for women.
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spelling doaj-art-14fa8f1bf6fa4e8eb6398fdef26ee6512025-08-20T01:52:22ZengKeAi Communications Co., Ltd.Laparoscopic, Endoscopic and Robotic Surgery2468-90092025-06-0182848910.1016/j.lers.2025.04.001Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysisVaishnavi J. Patel0Devki Patel1Kimberly Toumazos2Young Son3Komal Sharma4Virgil Kevin DeMario5Shelby Boock6Grace Lara7Alexandra McQuillen8Brianna Clark9University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USATexas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA; Corresponding author.University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USADepartment of Urology, Jefferson Health New Jersey, Stratford, NJ, USADepartment of OB/GYN, Houston Methodist Hospital, Houston, TX, USAUniversity of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USAPhiladelphia College of Osteopathic Medicine, Philadelphia, PA, USATouro University California College of Osteopathic Medicine, Vallejo, CA, USAPhiladelphia College of Osteopathic Medicine, Philadelphia, PA, USASunflower Lactation and Health Education, LLC, Joplin, MO, USAObjectives: Salpingectomy and tubal ligation are commonly performed for permanent contraception in women. Salpingectomy has been suggested to reduce the risk of ovarian cancer, but its comparative operative and perioperative risks have not been well established. The objective of this study is to compare the peri- and postoperative complications of laparoscopic tubal ligation with those of salpingectomy for permanent contraception. Methods: A retrospective review of 49,445 patients who underwent laparoscopic salpingectomy or tubal ligation for permanent contraception between 2017 and 2021 was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program database. Statistical analysis involved t test, chi-square test, and logistic regression analysis with the use of the random forest algorithm. The primary outcomes were perioperative and postoperative complications. Results: Of the total cohort, 45,307 (91.6%) underwent laparoscopic salpingectomy, and 4138 (8.4%) received laparoscopic tubal ligation. There were significant differences between the salpingectomy and tubal ligation groups with respect to several demographic characteristics, including age, BMI, minority status, and variations in past medical history. These demographic characteristics were controlled for in the multivariate regression analysis. Salpingectomy had a higher rate of operative and postoperative complications than did tubal ligation (OR = 1.78, 95% CI: 1.46–2.20, p < 0.001). Salpingectomy was associated with a greater risk of longer operation time (OR = 2.03, 95% CI: 2.02–2.04, p < 0.001), longer hospital stay (OR = 5.26, 95% CI: 4.57–6.09, p < 0.001), increased readmission (OR = 3.15, 95% CI: 1.92–5.65, p < 0.001), and increased unplanned reoperation (OR = 2.42, 95% CI: 1.32–5.12, p = 0.010). In addition, the occurrence rates of organ space surgical site infection (OR = 2.68, 95% CI: 1.21–7.59, p = 0.032) and sepsis (OR = 3.93, 95% CI: 1.48–16.02, p = 0.020) were significantly greater in the salpingectomy group than in the tubal ligation group. Conclusions: Laparoscopic tubal ligation and salpingectomy are both safe and effective procedures for permanent contraception; however, salpingectomy is more likely to be associated with peri- and postoperative complications. These findings may help guide clinical decision-making when selecting the optimal permanent contraception method for women.http://www.sciencedirect.com/science/article/pii/S246890092500026XSalpingectomyTubal ligationLaparoscopicContraceptionComplicationsSurgical outcomes
spellingShingle Vaishnavi J. Patel
Devki Patel
Kimberly Toumazos
Young Son
Komal Sharma
Virgil Kevin DeMario
Shelby Boock
Grace Lara
Alexandra McQuillen
Brianna Clark
Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis
Laparoscopic, Endoscopic and Robotic Surgery
Salpingectomy
Tubal ligation
Laparoscopic
Contraception
Complications
Surgical outcomes
title Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis
title_full Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis
title_fullStr Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis
title_full_unstemmed Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis
title_short Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis
title_sort peri and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception an acs nsqip analysis
topic Salpingectomy
Tubal ligation
Laparoscopic
Contraception
Complications
Surgical outcomes
url http://www.sciencedirect.com/science/article/pii/S246890092500026X
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