Palazón Pedro, Saura Laura, de Haro Irene, Martín-Solé Oriol, Albert Asteria, Tarrado Xavier, Julià Victoria
Department of Pediatric Surgery, Hospital Sant Joan de Déu-Universitat de Barcelona, Passeig de Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
Department of Pediatric Surgery, Hospital Sant Joan de Déu-Universitat de Barcelona, Passeig de Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
J Pediatr Surg. 2018 Oct;53(10):1945-1950. doi: 10.1016/j.jpedsurg.2018.01.011. Epub 2018 Jan 31.
Hirschsprung's disease (HD) is uncommon in females. There are very few reports on the patients' obstetric and gynecological outcome. Hydrosalpinx causes pain and infertility. It is rare in nonsexually active teenagers. It may be because of an intrinsic disease of the fallopian tubes or secondary to surgery.
to describe the relationship between hydrosalpinx and HD or its surgical approach; to report the impact of bilateral hydrosalpinx on fertility in HD.
The records of all females with HD since 1980 were reviewed. Only patients who reached menarche were included. Prevalence of hydrosalpinx and hydrosalpinx-free survival were compared after abdominoperineal (A) or transanal (T) surgery. Treatment for hydrosalpinx was reviewed.
Seventeen out of 27 patients had reached menarche (Group A: 13 patients; Group T: 4 patients). Five patients in group A and none in group T presented bilateral hydrosalpinx (p=0.261). There were no statistical differences in hydrosalpinx-free survival between groups (p=0.344). Hydrosalpinx treatment: two bilateral and one unilateral salpingectomy, one pyosalpinx evacuation and one untreated. Three patients had conception desire: one has children; two are on IVF program.
An association between hydrosalpinx and HD was observed. The development of hydrosalpinx was not associated with surgical approach in our study. Females with HD should have a gynecological follow-up for the development of hydrosalpinx, which can impair fertility.
Level III, retrospective comparative study.
先天性巨结肠症（HD）在女性中并不常见。关于此类患者产科和妇科结局的报道非常少。输卵管积水会导致疼痛和不孕。在未发生性行为的青少年中较为罕见。其原因可能是输卵管的内在疾病或手术所致。
描述输卵管积水与HD及其手术方式之间的关系；报告双侧输卵管积水对HD患者生育能力的影响。
回顾了自1980年以来所有女性HD患者的病历。仅纳入已初潮的患者。比较经腹会阴联合手术（A）或经肛门手术（T）后输卵管积水的患病率及无输卵管积水生存率。对输卵管积水的治疗情况进行了回顾。
27例患者中有17例已初潮（A组：13例患者；T组：4例患者）。A组有5例患者出现双侧输卵管积水，T组无（p = 0.261）。两组间无输卵管积水生存率无统计学差异（p = 0.344）。输卵管积水治疗情况：2例行双侧输卵管切除术、1例行单侧输卵管切除术、1例行输卵管积脓引流术、1例未治疗。3例有受孕意愿：1例已生育；2例正在接受体外受精治疗。
观察到输卵管积水与HD之间存在关联。在我们的研究中，输卵管积水的发生与手术方式无关。HD女性患者应接受妇科随访，以监测可能影响生育能力的输卵管积水的发生。
III级，回顾性比较研究。
