Salpingectomy vs Tubal Ligation for Sterilization: A Systematic Review and Meta-analysis

摘要

The association between removal of the fallopian tubes and decreased risk of ovarian cancer is well documented. Although complete removal of the fallopian tubes (salpingectomy) for the prevention of ovarian cancer seems promising, no unequivocal evidence supports this practice in women seeking sterilization. Several investigators have described methods of minimally invasive interruption of the fallopian tubes (tubal ligation) without requiring complete removal. Routine salpingectomy has been performed at the time of removal of the ovaries with hysterectomy, but was rarely performed for the purpose of sterilization before the American College of Obstetricians and Gynecologists published Committee Opinion Number 620 in 2015. There has been a trend in recent years toward "opportunistic" salpingectomy to decrease risk of ovarian cancer. It is now generally accepted that salpingectomy is the preferred method of sterilization inmost cases; however, clinical concerns and reimbursement barriers have impeded universal consensus in the United States that salpingectomy is preferable to tubal ligation.