Tulandi T, Falcone T, Kafka I
Fertility Center, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Fertil Steril. 1989 Sep;52(3):421-4. doi: 10.1016/s0015-0282(16)60911-1.
To evaluate the efficacy of a second-look operative laparoscopy following a reproductive surgery, a randomized study was conducted on women who failed to conceive 1 year following terminal salpingostomy or following salpingo-ovariolysis by laparotomy. There is no significant difference in the cumulative probability of pregnancy at 12, 24, and 36 months follow-up between women who underwent second-look operative laparoscopy 1 year after salpingo-ovariolysis (27%, 67%, and 67%) and women who were continued to be observed expectantly (27%, 45%, and 52%, respectively). The cumulative probability of conception at 12, 24, and 36 months follow-up in women who underwent second-look laparoscopy 1 year after salpingostomy was 6%, 18%, and 18% and in women who were observed expectantly was 5%, 21%, and 27%, respectively (P = no significant). The incidence of ectopic pregnancy which was high (about one-half of patients who conceived) was also not affected by this procedure. This study suggests that second-look operative laparoscopy 1 year after terminal salpingostomy or salpingo-ovariolysis does not increase the pregnancy rate or decrease the incidence of ectopic pregnancy. Women who fail to conceive 1 year after a reproductive surgery still maintain some of their reproductive potential, but the risk of having an ectopic pregnancy is high.
为评估生殖手术后二次腹腔镜手术的疗效，对输卵管造口术或剖腹输卵管卵巢松解术后1年仍未受孕的女性进行了一项随机研究。输卵管卵巢松解术后1年接受二次腹腔镜手术的女性（妊娠累积概率分别为27%、67%和67%）与继续进行观察等待的女性（妊娠累积概率分别为27%、45%和52%）在随访12、24和36个月时的妊娠累积概率无显著差异。输卵管造口术后1年接受二次腹腔镜检查的女性在随访12、24和36个月时的受孕累积概率分别为6%、18%和18%，观察等待的女性分别为5%、21%和27%（P值无显著性差异）。异位妊娠发生率较高（约占受孕患者的一半），该手术对此也无影响。本研究表明，输卵管造口术或输卵管卵巢松解术后1年进行二次腹腔镜手术不会提高妊娠率或降低异位妊娠发生率。生殖手术后1年仍未受孕的女性仍保留一定的生殖潜能，但发生异位妊娠的风险较高。
