Canis M, Mage G, Pouly J L, Manhes H, Wattiez A, Bruhat M A
Department of Obstetrics, Gynecology, and Reproductive Medicine, Polyclinique de l'Hôtel Dieu, Centre Hospitalier Régional et Universitaire, Clermont-Ferrand, France.
Fertil Steril. 1991 Oct;56(4):616-21. doi: 10.1016/s0015-0282(16)54589-0.
To evaluate fertility results after laparoscopic distal tuboplasty and to compare these results with those obtained previously with microsurgery.
Retrospective, nonrandomized.
Department of Obstetrics and Gynecology at the University Hospital of Clermont-Ferrand, France.
All the distal tuboplasties performed between October 1985 and June 1989 were included. Adnexal damage was assessed using tubal and adhesions scoring systems described previously. Tuboplasty was carried out bilaterally except when one tube was absent or severely damaged (tubal stage III or IV and/or with severe adhesions). Patients with bilateral severe adnexal damages were treated only if they refused to undergo in vitro fertilization. Laparoscopic tuboplasty was performed either with the CO2 laser or with conventional instruments.
Fertility after laparoscopic treatment was evaluated using simple and cumulative pregnancy rates (PRs) according to the adnexal damage and compared with the microsurgical results using PRs according to the adnexal damage.
The overall intrauterine and extrauterine PRs were 33.3% and 6.9%, respectively. Twenty-six of the 29 intrauterine pregnancies were obtained within the 1st postoperative year. According to tubal and adhesion stages, the results of laparoscopic distal tuboplasty are similar to those obtained using microsurgery.
We conclude that laparoscopic distal tuboplasty, when performed by experienced surgical laparoscopists, represents an effective alternative to microsurgery.
评估腹腔镜远端输卵管成形术后的生育结果，并将这些结果与先前显微手术获得的结果进行比较。
回顾性、非随机研究。
法国克莱蒙费朗大学医院妇产科。
纳入1985年10月至1989年6月期间进行的所有远端输卵管成形术病例。使用先前描述的输卵管和粘连评分系统评估附件损伤情况。除非一侧输卵管缺如或严重受损（输卵管III期或IV期和/或伴有严重粘连），否则双侧均进行输卵管成形术。仅当双侧严重附件损伤患者拒绝接受体外受精时才对其进行治疗。腹腔镜输卵管成形术采用二氧化碳激光或传统器械进行。
根据附件损伤情况，采用简单妊娠率和累积妊娠率评估腹腔镜治疗后的生育情况，并与根据附件损伤情况采用妊娠率的显微手术结果进行比较。
总体宫内妊娠率和宫外妊娠率分别为33.3%和6.9%。29例宫内妊娠中有26例在术后第1年获得。根据输卵管和粘连分期，腹腔镜远端输卵管成形术的结果与显微手术的结果相似。
我们得出结论，由经验丰富的腹腔镜外科医生进行的腹腔镜远端输卵管成形术是显微手术的一种有效替代方法。
