Langer R, Bukovsky I, Herman A, Ron-El R, Lifshitz Y, Caspi E
Department of Obstetrics and Gynecology, Assaf Harofe Government Hospital, Sackler School of Medicine, Tel-Aviv University, Zerifin, Israel.
Acta Obstet Gynecol Scand. 1987;66(7):649-52. doi: 10.3109/00016348709022073.
Eighty seven conservative surgical interventions for unruptured tubal pregnancy were performed on 83 patients. Salpingotomy was performed in 66 cases and expression of tubal pregnancy in 21 cases. In this patient group, 76.7% (56 out of 73) experienced intra-uterine pregnancy following surgery and 71.2% (52 out of 73) had a live birth. The recurrence rate of tubal pregnancy was 12.3%. Of the 42 patients with a normal contralateral tube, 36 (85.7%) had an intra-uterine pregnancy, 80.9% had a live birth and 7.1% had a recurrent tubal pregnancy. Sixty percent of the patients who underwent operation on their single tube, had a live birth and 66.6% had an intra-uterine pregnancy; the recurrence of tubal pregnancy in this group was 26.6%. No recurrence of tubal pregnancy was found in the group of patients who underwent expression of tubal gestation. It is suggested that the expression of tubal gestation (milking) is a safe procedure for conserving future fertility, and that the indications for conservative surgical management in patients with unruptured tubal gestation should be broadened to include all patients interested in future pregnancies, regardless of the current state of the contralateral tube.
对83例患者实施了87例未破裂输卵管妊娠的保守性手术干预。其中66例行输卵管切开术，21例行输卵管妊娠挤出术。在该患者组中，76.7%（73例中的56例）术后发生宫内妊娠，71.2%（73例中的52例）活产。输卵管妊娠复发率为12.3%。在对侧输卵管正常的42例患者中，36例（85.7%）发生宫内妊娠，80.9%活产，7.1%发生输卵管妊娠复发。在单管手术的患者中，60%活产，66.6%发生宫内妊娠；该组输卵管妊娠复发率为26.6%。在接受输卵管妊娠挤出术的患者组中未发现输卵管妊娠复发。提示输卵管妊娠挤出术（挤奶法）是一种保留未来生育能力的安全手术，对于未破裂输卵管妊娠患者，保守性手术治疗的适应证应扩大到所有有未来妊娠意愿的患者，而不论对侧输卵管的现状如何。
