مقايسه عوارض زودرس و ديررس بستن لوله هاي رحمي با لاپاراسكوپ در سه روش رينگ - فيليش كليپ و الكتروگواگولاسيون دو قطبي

COMPARISON OF SHORT AND LONG TERM COMPLICATIONS OF THREE METHODS OF LAPARASCOPIC TUBAL LIGATION

BACKGROUND AND OBJECTIVE: The aim of this study was to compare short and long term complications of three modalities of laparascopic tubal ligation by bipolar electrocoagulation, double ring and filishi clip. METHODS: This analytical study as a prospective trial was performed on gynecologic center of Babol University of medical sciences between 1996-2002. In this study, 334 patients (187 by biopolar electrocoagulation, 50 by applying filishi clip and 97 by applying sialastic double ring) were operated by general anesthesia after including in the criteria: medical health, voluntarily request, without age limit and in the first half of cycle. After evaluation of their early and late complications, data was analyzed by t-test and Chi- square test. FINDINGS: Early complications including mesosalpinx tearing and hematoma formation were happened in four cases of ring (4.2%) and one case of electrocoagulation (0.5%). Techniqual performance, post operation chest pain and hospital stay were equal among three modalities. Pelvic pain has been observed in 19.4% ring group, 7% electrocoagulation group and 6% flishi clip group following surgery. Complete recovery was obtained in 24 hrs for electrocoagulation and filishi group were 47.6% and 58%, respectively and 9% for ring method but within 48 hrs, it was obtained 53.6% for ring group, 9.6% for electrocoagulation group and 10% for filishi clip. Late complications, which were assessed after two years of operations, have been equal in three modalities. Only one case of pregnancy (ring method) has been detected among the whole cases. Mean (±SD) operation times were 8.4 (±2.5) min, 11.8 (±1.6) min and 11.9 (±1.5) min for electrocoagulation, ring and filishi clip, respectively. CONCLUSION: Ring method of laparascopic tubal ligation has more early and late complications relative to electrocoagulation and filishi methods, and using single puncture bipolar electrocoagulation can be the fastest procedure among the above three modalities.