Reich H
Nesbitt Memorial Hospital, Kingston, Pennsylvania.
J Reprod Med. 1987 Oct;32(10):736-42.
Sixty-seven women with extensive pelvic adhesions, including hydrosalpinx, underwent a laparoscopic surgical procedure over the past eight years. Only cases in which ovum pickup was greatly impaired by adhesions were included. Cases of extensive endometriosis or acute adhesions were excluded. Recent innovations in technique were used, including aquadissection, electrodissection, scissors dissection and laparoscopic suturing. Two women suffered transient unilateral brachial plexus injury; there were no other complications. No laparotomies were required. The viable pregnancy rate was 78% (21 of 27) for women who underwent salpingoovariolysis on the most favorable adnexa and 28.5% (2 of 7) for those with salpingostomy for hydrosalpinx. There was one ectopic pregnancy (3%). The outcome for 34 laparoscopically treated women compared favorably with that for 30 women with similar tubal factor infertility who were treated with laparotomy microsurgery; the viable pregnancy rate was 75% (9 of 12) for laparotomy salpingoovariolysis and 53% (8 of 15) for laparotomy salpingostomy, with an ectopic rate of 13% (4 of 30).
在过去八年中，67名患有包括输卵管积水在内的广泛盆腔粘连的女性接受了腹腔镜手术。仅纳入粘连严重影响卵子拾取的病例。广泛子宫内膜异位症或急性粘连的病例被排除。采用了包括水分离、电分离、剪刀分离和腹腔镜缝合在内的最新技术创新。两名女性出现短暂性单侧臂丛神经损伤；无其他并发症。无需开腹手术。对最有利附件进行输卵管卵巢粘连松解术的女性，其活产妊娠率为78%（27例中的21例），输卵管积水行输卵管造口术的女性活产妊娠率为28.5%（7例中的2例）。有1例宫外孕（3%）。34名接受腹腔镜治疗的女性的结局与30名接受开腹显微手术治疗的输卵管因素不孕症相似的女性相比更优；开腹输卵管卵巢粘连松解术的活产妊娠率为75%（12例中的9例），开腹输卵管造口术的活产妊娠率为53%（15例中的8例），宫外孕率为13%（30例中的4例）。
