Reich H, McGlynn F, Salvat J
Wyoming Valley GYN/OB Associates, Kingston, Pennsylvania 18704.
J Reprod Med. 1991 Jul;36(7):516-22.
One hundred women with cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis (48 partial, 52 complete) were treated laparoscopically for infertility (46 cases), pain (46), hypermenorrhea (7) and a mass (1). The surgical techniques included aqua-dissection, electrosurgery, CO2 laser, scissors, probes to identify the upper posterior vagina and rectum, and multiple rectovaginal examinations. In all the procedures the anterior rectum was freed to the loose areolar tissue of the rectovaginal septum prior to excising deep fibrotic endometriosis. The viable intrauterine pregnancy rate among patients with infertility was 70% (32/46). Of patients presenting with pain, 89% (41/46) reported significant relief. The average operating time was 178 minutes. Laparoscopic cul-de-sac dissection, though time intensive, offers increased fertility potential and significant symptom relief.
100例因宫颈后深部纤维化子宫内膜异位症导致直肠子宫陷凹闭锁的女性（48例部分闭锁，52例完全闭锁）接受了腹腔镜手术治疗，治疗原因包括不孕症（46例）、疼痛（46例）、月经过多（7例）和肿块（1例）。手术技术包括水分离、电外科手术、二氧化碳激光、剪刀、用于识别阴道后上部和直肠的探针以及多次直肠阴道检查。在所有手术中，在切除深部纤维化子宫内膜异位症之前，先将直肠前部游离至直肠阴道隔的疏松乳晕组织。不孕症患者的活产宫内妊娠率为70%（32/46）。出现疼痛的患者中，89%（41/46）报告症状明显缓解。平均手术时间为178分钟。腹腔镜直肠子宫陷凹分离术虽然耗时，但能提高生育潜力并显著缓解症状。
