Faculté de Médecine, Université Paris-Sud, Le Kremlin Bicêtre, F-94274 Paris, France.
Arch Gynecol Obstet. 2011 May;283(5):1149-58. doi: 10.1007/s00404-011-1858-1. Epub 2011 Feb 18.
To evaluate various techniques for restoring tubal patency after sterilisation.
A search strategy was designed, and for each subject either thesaurus terms (MeSH descriptors) or terms from the title or summary were used.
Mean length of hospital stay following laparoscopy seems to be shorter in comparison with laparotomy (3.3 vs. 6.1 days, P < 0.05). Rate of conversion to laparotomy is 5%. Pregnancy rates observed are between 54 and 88% for laparotomy and 31-85% for laparoscopy. Mean time to conception was between 2 and 9.6 months. Most pregnancies occurred in the 2 years following restoration of tubal patency (cumulative conception rate 80% at 12 months). Young age (<35 years), type of ligature (rings), how recently the ligature was done (<8 years), the anastomosis site (in the middle of the tube) and a good length of remaining tube (>7 cm) are the factors that govern whether there can be good restoration of tubal patency. Ectopic pregnancy rates observed are between 1.7 and 12% for laparotomy and 0-7% for laparoscopy. There are no randomised or quasi-randomised studies comparing tubal anastomosis and in vitro fertilization.
There are few good-quality controlled studies in this area. Results of restoration of tubal patency seem to be comparable, regardless of the route of approach (laparotomy or laparoscopy).
评估绝育后恢复输卵管通畅的各种技术。
设计了一种搜索策略，对于每个主题，使用词表术语（MeSH 描述符）或标题或摘要中的术语。
腹腔镜检查后的住院时间平均似乎比剖腹手术短（3.3 天与 6.1 天，P<0.05）。剖腹手术中转开腹的比例为 5%。剖腹手术的妊娠率为 54%至 88%，腹腔镜检查的妊娠率为 31%至 85%。受孕的平均时间为 2 至 9.6 个月。大多数妊娠发生在恢复输卵管通畅后的 2 年内（12 个月时累积妊娠率为 80%）。年龄较小（<35 岁）、结扎类型（环）、结扎时间（<8 年）、吻合部位（管中部）和剩余管长度（>7cm）是决定输卵管通畅能否良好恢复的因素。剖腹手术的异位妊娠率为 1.7%至 12%，腹腔镜检查的异位妊娠率为 0%至 7%。没有比较输卵管吻合术和体外受精的随机或准随机研究。
该领域的高质量对照研究较少。无论采用哪种方法（剖腹手术或腹腔镜手术），输卵管通畅恢复的结果似乎都可以比较。
