Ferrero Simone, Anserini Paola, Abbamonte Luiza Helena, Ragni Nicola, Camerini Giovanni, Remorgida Valentino
Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Largo R. Benzi 1, Genoa, Italy.
Fertil Steril. 2009 Jul;92(1):41-6. doi: 10.1016/j.fertnstert.2008.04.070. Epub 2008 Aug 5.
To determine the pregnancy rate after bowel resection for rectosigmoid endometriosis.
Prospective cohort study.
University hospital.
PATIENT(S): Forty-six symptomatic women with bowel endometriosis requiring colorectal resection.
INTERVENTION(S): Bowel resection by either laparoscopy or laparotomy.
MAIN OUTCOME MEASURE(S): Pregnancy rate after surgery.
RESULT(S): The pregnancy rate was higher in women who underwent bowel resection by laparoscopy (57.6%) than in those who underwent laparotomy (23.1%). No significant difference was observed in pregnancy rate and mode of conception between women with different fertility status before bowel resection. Women who conceived were significantly younger than those who did not conceive; only 26.7% of women aged > or =35 years conceived after bowel resection. Uterine adenomyosis was more frequently present in women who did not conceive than in those who conceived. Infertile women who conceived had a shorter length of infertility before surgery than those who did not conceive.
CONCLUSION(S): Laparoscopic colorectal resection is less likely to impact negatively on fertility than the laparotomy approach. Previous laparotomies, age > or =35 years, uterine adenomyosis, and longer duration of infertility before surgery are associated with decreased pregnancy rate.
确定直肠乙状结肠子宫内膜异位症肠切除术后的妊娠率。
前瞻性队列研究。
大学医院。
46例有症状的肠道子宫内膜异位症且需要进行结直肠切除的女性。
通过腹腔镜或开腹进行肠切除。
术后妊娠率。
接受腹腔镜肠切除的女性妊娠率（57.6%）高于接受开腹手术的女性（23.1%）。在肠切除术前不同生育状态的女性中，妊娠率和受孕方式未观察到显著差异。受孕的女性明显比未受孕的女性年轻；肠切除术后，年龄≥35岁的女性中只有26.7%受孕。未受孕女性比受孕女性更常出现子宫腺肌病。受孕的不孕女性术前不孕时间比未受孕的不孕女性短。
与开腹手术相比，腹腔镜结直肠切除对生育能力产生负面影响的可能性较小。既往开腹手术、年龄≥35岁、子宫腺肌病以及术前不孕时间较长与妊娠率降低有关。
