Trends in Surgical Sterilization at an Academic Medical Center: Are We Being Opportunistic? [28J]. (May 2020)

• Record Type: Journal Article
• Authors: Barrows, Emily; Truong, Mireille; Johnson, Molly; Siff, Lauren
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000664348.03443.0a
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: In the age of evidence-based medicine, physicians are expected to adapt quickly to changing recommendations. The Society of Gynecologic Oncology (SGO) released a practice statement in November 2013 recommending providers consider performing salpingectomy concurrently with other pelvic surgeries for prevention of epithelial ovarian cancers. This study evaluates practice changes from tubal ligation to salpingectomy for surgical sterilization at an academic center following these recommendations. METHODS: This IRB approved, retrospective cohort study evaluated interval surgical sterilization procedures performed in an academic medical center between 1/1/2012 and 12/31/2018. Descriptive statistics compared rates of salpingectomy with tubal ligation before and after 1/1/2014, as well as annually. A multivariable regression model was fit to the data to adjust for potential confounding differences between populations. RESULTS: 243 surgical sterilization procedures were performed during the study time period. Salpingectomy accounted for 0/64 (0%) prior to the recommendation release and 86/168 (51.19%) after the release, (P<.0001). Rate of salpingectomies increased annually: 3/31 (9.7%) in 2014, 9/35 (20.5%) in 2015, 16/32 (50.0%) in 2016, 22/23 (95.7%) in 2017, 36/38 (94.7%) in 2018, (P<.0001). Adjusting for potentially clinically relevant differences in the populations, the only other variable associated with type of sterilization was insurance, ( P= .0279). Mean surgical duration was 8.5 minutes longer after the recommendation release, ( P= .0019). There were no differences in blood loss, intraoperative or postoperative complications. CONCLUSION: Significant practice change in sterilization method from tubal ligation to salpingectomy occurred immediately following the SGO recommendations, however complete adoption of these recommendations (defined as 95% of procedures) took 4 years to achieve.