J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website http://www.jcgo.org

Original Article

Volume 8, Number 3, September 2019, pages 70-76

Opportunistic Salpingectomy Techniques at the Time of Cesarean Delivery: A Retrospective Cohort Study

**Table 1.** Clinical and Demographic Characteristics of Women Who Underwent Salpingectomies at Cesarean Delivery by Surgical Technique
	Bipolar electrocautery (n = 97)	Suture ligation (n = 97)	P-value^a
^aStatistical tests used: t-test for continuous variable and Chi-square tests or Fisher’s exact tests (when expected cell size < 5) for categorical variables.
Demographic characteristics
Age (years), mean (SD)	34.59 (4.6)	35.30 (4.2)	0.26
Parity, n (%)			0.56
0	0 (0)	1 (1.03)
1 - 2	42 (43.30)	46 (47.42)
≥ 3	55 (56.70)	50 (51.55)
Race/ethnicity, n (%)			0.40
Asian	20 (20.62)	28 (28.87)
Black	8 (8.25)	5 (5.15)
Hispanic	27 (27.84)	27 (27.84)
White	36 (37.11)	35 (36.08)
Other/unknown	6 (6.19)	2 (2.06)
Households below poverty level, n (%)			0.88
Greater than 10%	34 (35.05)	33 (34.02)
Less than 10%	63 (64.95)	64 (65.98)
Clinical characteristics
Body mass index (kg/m²), n (%)			0.71
< 30	29 (29.90)	28 (29.17)
30 - 39.9	51 (52.58)	55 (57.29)
≥ 40	17 (17.53)	13 (13.54)
History of abdominal surgery, n (%)	87 (89.69)	88 (90.72)	0.81
History of fallopian tube surgery, n (%)	1 (1.03)	3 (3.09)	0.62
History of endometriosis, n (%)	4 (4.12)	2 (2.06)	0.68
Cesarean indication, n (%)			0.79
Non-reassuring fetal heart rate tracing	1 (1.03)	2 (2.06)
Arrest of labor	3 (3.09)	1 (1.03)
Elective repeat cesarean	86 (88.66)	86 (88.66)
Other	7 (7.22)	8 (8.25)
Service area, n (%)			< 0.001
A	8 (8.25)	38 (39.18)
B	0 (0)	1 (1.03)
C	0 (0)	5 (5.15)
D	63 (64.95)	1 (1.03)
E	0 (0)	35 (36.08)
F	26 (26.80)	17 (17.53)
Study year, n (%)			< 0.001
June 2011 - May 2012	0	1 (1.03)
June 2012 - May 2013	0	2 (2.06)
June 2013 - May 2014	3 (3.09)	14 (14.43)
June 2014 - May 2015	25 (25.77)	34 (35.05)
June 2015 - May 2016	69 (71.13)	46 (47.42)

Table 1. Clinical and Demographic Characteristics of Women Who Underwent Salpingectomies at Cesarean Delivery by Surgical Technique

Bipolar electrocautery (n = 97)

Suture ligation (n = 97)

P-value^a

^aStatistical tests used: t-test for continuous variable and Chi-square tests or Fisher’s exact tests (when expected cell size < 5) for categorical variables.

Demographic characteristics

Age (years), mean (SD)

34.59 (4.6)

35.30 (4.2)

0.26

Parity, n (%)

0.56

0 (0)

1 (1.03)

1 - 2

42 (43.30)

46 (47.42)

≥ 3

55 (56.70)

50 (51.55)

Race/ethnicity, n (%)

0.40

Asian

20 (20.62)

28 (28.87)

Black

8 (8.25)

5 (5.15)

Hispanic

27 (27.84)

White

36 (37.11)

35 (36.08)

Other/unknown

6 (6.19)

2 (2.06)

Households below poverty level, n (%)

0.88

Greater than 10%

34 (35.05)

33 (34.02)

Less than 10%

63 (64.95)

64 (65.98)

Clinical characteristics

Body mass index (kg/m²), n (%)

0.71

< 30

29 (29.90)

28 (29.17)

30 - 39.9

51 (52.58)

55 (57.29)

≥ 40

17 (17.53)

13 (13.54)

History of abdominal surgery, n (%)

87 (89.69)

88 (90.72)

0.81

History of fallopian tube surgery, n (%)

1 (1.03)

3 (3.09)

0.62

History of endometriosis, n (%)

4 (4.12)

2 (2.06)

0.68

Cesarean indication, n (%)

0.79

Non-reassuring fetal heart rate tracing

1 (1.03)

2 (2.06)

Arrest of labor

3 (3.09)

1 (1.03)

Elective repeat cesarean

86 (88.66)

Other

7 (7.22)

8 (8.25)

Service area, n (%)

< 0.001

8 (8.25)

38 (39.18)

0 (0)

1 (1.03)

0 (0)

5 (5.15)

63 (64.95)

1 (1.03)

0 (0)

35 (36.08)

26 (26.80)

17 (17.53)

Study year, n (%)

< 0.001

June 2011 - May 2012

1 (1.03)

June 2012 - May 2013

2 (2.06)

June 2013 - May 2014

3 (3.09)

14 (14.43)

June 2014 - May 2015

25 (25.77)

34 (35.05)

June 2015 - May 2016

69 (71.13)

46 (47.42)

**Table 2.** Perioperative Outcomes of Salpingectomies at Cesarean Delivery by Surgical Technique
	Bipolar electrocautery (n = 97)	Suture ligation (n = 97)	P-value^a
^aStatistical tests used: non-parametric Kruskal-Wallis for continuous variables and Chi-square tests or Fisher’s exact tests (when expected cell size < 5) for categorical variables. IQR: interquartile range.
Intraoperative characteristics
Surgery time (min), median (IQR)	59 (46 - 71)	65 (52 - 80)	0.06
Operating room time (min), median (IQR)	96 (83 - 112)	104 (89 - 120)	0.046
Number of surgeons			< 0.001
1	8 (8.25)	30 (30.93)
2	84 (86.60)	61 (62.89)
3	5 (5.15)	6 (6.19)
Intraoperative complications	4 (4.12)	4 (4.12)	1.0
Estimated blood loss (mL), median (IQR)	600 (445 - 800)	760 (500 - 864)	0.04
Postoperative characteristics
Blood transfusions, n (%)	1(1.03)	1 (1.03)	1.0
Length of stay (h), median (IQR)	53 (49 - 72)	52 (48 - 71)	0.28
Readmission within 30 days, n (%)	10 (10.4)	10 (10.4)	0.96
Emergency room visit within 7 days, n (%)	0	0	n/a

Table 2. Perioperative Outcomes of Salpingectomies at Cesarean Delivery by Surgical Technique

Bipolar electrocautery (n = 97)

Suture ligation (n = 97)

P-value^a

^aStatistical tests used: non-parametric Kruskal-Wallis for continuous variables and Chi-square tests or Fisher’s exact tests (when expected cell size < 5) for categorical variables. IQR: interquartile range.

Intraoperative characteristics

Surgery time (min), median (IQR)

59 (46 - 71)

65 (52 - 80)

0.06

Operating room time (min), median (IQR)

96 (83 - 112)

104 (89 - 120)

0.046

Number of surgeons

< 0.001

8 (8.25)

30 (30.93)

84 (86.60)

61 (62.89)

5 (5.15)

6 (6.19)

Intraoperative complications

4 (4.12)

1.0

Estimated blood loss (mL), median (IQR)

600 (445 - 800)

760 (500 - 864)

0.04

Postoperative characteristics

Blood transfusions, n (%)

1(1.03)

1 (1.03)

1.0

Length of stay (h), median (IQR)

53 (49 - 72)

52 (48 - 71)

0.28

Readmission within 30 days, n (%)

10 (10.4)

0.96

Emergency room visit within 7 days, n (%)

n/a

**Table 3.** Multivariable Comparison of Bipolar Electrocautery Vs. Suture Ligation (Reference) for Select Perioperative Outcomes
Perioperative outcome	Adjusted model^a	Adjusted hierarchical model
Number of surgeons	3.09 (1.53, 6.23)	2.72 (0.39, 18.79)
^aEach row represents a separate model run for each perioperative outcome, adjusting for body mass index and history of abdominal surgery. The hierarchical models take into account correlation within each of the six medical service areas using a random intercept. Number of surgeons is an ordinal logistic regression. All other variables use linear regression. OR: odds ratio; CI: confidence interval.
Length of stay (h)	4.14 (-0.96, 9.24)	3.85 (-6.30, 14.01)
Operating room time (min)	-6.90 (-14.17, 0.36)	-10.67 (-22.06, 0.71)
Surgery time (min)	-5.33 (-11.68, 1.03)	-10.74 (-21.00, -0.49)
Estimated blood loss (mL)	-53.3 (-148.6, 41.9)	-81.7 (-232.0, 68.7)

Table 3. Multivariable Comparison of Bipolar Electrocautery Vs. Suture Ligation (Reference) for Select Perioperative Outcomes

Perioperative outcome

Adjusted model^a

Adjusted hierarchical model

OR (95% CI)

Number of surgeons

3.09 (1.53, 6.23)

2.72 (0.39, 18.79)

Difference β (95% CI)

^aEach row represents a separate model run for each perioperative outcome, adjusting for body mass index and history of abdominal surgery. The hierarchical models take into account correlation within each of the six medical service areas using a random intercept. Number of surgeons is an ordinal logistic regression. All other variables use linear regression. OR: odds ratio; CI: confidence interval.

Length of stay (h)

4.14 (-0.96, 9.24)

3.85 (-6.30, 14.01)

Operating room time (min)

-6.90 (-14.17, 0.36)

-10.67 (-22.06, 0.71)

Surgery time (min)

-5.33 (-11.68, 1.03)

-10.74 (-21.00, -0.49)

Estimated blood loss (mL)

-53.3 (-148.6, 41.9)

-81.7 (-232.0, 68.7)