Zhang Lei, Zhao Jun, Bai Yun, Liu Xiuping
Department of Obstetrics and Gynecology, the Third Hospital of Hebei Medical University, Shijiazhuang City, 050051, People's Republic of China.
Int J Womens Health. 2022 Aug 4;14:1007-1013. doi: 10.2147/IJWH.S367948. eCollection 2022.
This study aimed to compare fertility outcomes in patients who underwent different laparoscopic surgeries and to determine the most beneficial surgical treatment for tubal ectopic pregnancy (EP) patients who wished to become pregnant in the future.
In this retrospective study, patients aged 18-36 years, who had been diagnosed with a tubal EP in our hospital, were enrolled. Based on the treatment methods, the patients were divided into three groups, ie a salpingectomy group, a salpingotomy with suturing group and a salpingotomy without suturing group. The follow-up time for the enrolled patients was more than three years. Serum beta (β)-human chorionic gonadotropin (β-HCG) levels were monitored after surgery. The intrauterine pregnancy (IUP) rate at 12, 24 and 36 months postoperatively, and recurrent EP rate were compared.
The median time for β-HCG level returning to normal in the salpingectomy group was much shorter than in the salpingotomy with suturing or salpingotomy without suturing groups (P < 0.001). The 12, 24 and 36-month IUP rates among the three groups were not significantly different. A recurrent EP was found in only one patient in the salpingotomy with suturing group and two patients in the salpingotomy without suturing group.
In this study, we found that salpingectomy and salpingotomy with or without suturing methods reflected no significant differences in fertility outcomes for tubal EP patients.
本研究旨在比较接受不同腹腔镜手术的患者的生育结局，并确定对未来希望怀孕的输卵管异位妊娠（EP）患者最有益的手术治疗方法。
在这项回顾性研究中，纳入了在我院被诊断为输卵管EP的18至36岁患者。根据治疗方法，将患者分为三组，即输卵管切除术组、缝合输卵管切开术组和非缝合输卵管切开术组。纳入患者的随访时间超过三年。术后监测血清β-人绒毛膜促性腺激素（β-HCG）水平。比较术后12、24和36个月的宫内妊娠（IUP）率和复发性EP率。
输卵管切除术组β-HCG水平恢复正常的中位时间比缝合输卵管切开术组或非缝合输卵管切开术组短得多（P<0.001）。三组的12、24和36个月IUP率无显著差异。缝合输卵管切开术组仅1例患者发生复发性EP，非缝合输卵管切开术组有2例患者发生复发性EP。
在本研究中，我们发现输卵管切除术和缝合或不缝合的输卵管切开术方法在输卵管EP患者的生育结局方面无显著差异。
