Dubuisson J B, Bouquet de Jolinière J, Aubriot F X, Daraï E, Foulot H, Mandelbrot L
Service de Gynécologie-Obstétrique, Clinique Universitaire Port-Royal, Paris, France.
Fertil Steril. 1990 Sep;54(3):401-3. doi: 10.1016/s0015-0282(16)53751-0.
A series of 65 consecutive laparoscopic distal tuboplasties, performed from May 1986 to May 1988 is reported. Thirty-one were fimbrioplasties and 34 were neosalpingostomies. Outcome was evaluated at 18 months postoperatively. Twenty-two patients obtained pregnancies (33.8%), of which 18 were intrauterine (27.7%). The intrauterine pregnancy rate was 25.8% after fimbrioplasty and 29.4% after neosalpingostomy. These results are comparable with those obtained after microsurgery. Progress in operative laparoscopy may be attributed to the development of an appropriate atraumatic instrumentation and the CO2 laser. The major advantage of laparoscopic techniques is their availability at the time of diagnostic laparoscopy. Immediate opening of hydrosalpinges allows for precise evaluation of the tubal mucosa, thereby establishing prognosis. In cases with a severely altered mucosa, in vitro fertilization may be considered immediately. When the mucosa is satisfactory, laparoscopic fimbrioplasty or neosalpingostomy may be performed. Within 1 year after one of these procedures, a pregnancy is generally achieved in 1 of 3 patients.
本文报告了1986年5月至1988年5月连续进行的65例腹腔镜远端输卵管成形术。其中31例为输卵管伞端成形术，34例为新造口术。术后18个月评估结果。22例患者怀孕（33.8%），其中18例为宫内妊娠（27.7%）。输卵管伞端成形术后宫内妊娠率为25.8%，新造口术后为29.4%。这些结果与显微手术后的结果相当。手术腹腔镜的进展可能归因于合适的无创器械和二氧化碳激光的发展。腹腔镜技术的主要优点是在诊断性腹腔镜检查时即可使用。立即打开输卵管积水可精确评估输卵管黏膜，从而确定预后。对于黏膜严重改变的病例，可立即考虑体外受精。当黏膜状况良好时，可进行腹腔镜输卵管伞端成形术或新造口术。在进行这些手术之一后的1年内，通常每3例患者中有1例怀孕。
