Lavy G, Diamond M P, DeCherney A H
Fertil Steril. 1986 Jul;46(1):21-5. doi: 10.1016/s0015-0282(16)49451-3.
We have reviewed the pregnancy rate and outcome of 25 patients who underwent tubocornual anastomosis for correction of proximal tubal occlusion at Yale-New Haven Hospital between 1977 and 1981. Tubal occlusion was the result of previous tubal sterilization in 17 patients (11 laparoscopic electrocautery and 6 tubal ligation) and previous tubal infection in 8. Fourteen of the patients conceived (56%). Viable pregnancy was achieved in nine patients (36%) and tubal pregnancy in three (12%). No significant difference in pregnancy rates was found between patients with diseased cornua and those previously sterilized by either electrocautery or tubal ligation. Tubal length of greater than or equal to 4 cm following corrective surgery as compared with less than or equal to 4 cm did not influence pregnancy rates. The patients with the shorter oviducts had a higher rate of early pregnancy wastage. All three tubal pregnancies occurred in patients with reoccluded fallopian tubes as demonstrated by a hysterosalpingogram. We conclude that tubocornual anastomosis still remains the treatment of choice for patients with proximal tubal obstruction.
我们回顾了1977年至1981年间在耶鲁-纽黑文医院接受输卵管角部吻合术以纠正近端输卵管阻塞的25例患者的妊娠率和妊娠结局。输卵管阻塞的原因是，17例患者（11例为腹腔镜电灼绝育术，6例为输卵管结扎绝育术）既往有输卵管绝育史，8例既往有输卵管感染史。14例患者受孕（56%）。9例患者实现了活产妊娠（36%），3例发生了输卵管妊娠（12%）。患侧子宫角患者与既往接受电灼绝育术或输卵管结扎绝育术的患者之间的妊娠率无显著差异。矫正手术后输卵管长度大于或等于4 cm与小于或等于4 cm相比，对妊娠率没有影响。输卵管较短的患者早期妊娠流产率较高。子宫输卵管造影显示，所有3例输卵管妊娠均发生在输卵管再次阻塞的患者中。我们得出结论，输卵管角部吻合术仍是近端输卵管阻塞患者的首选治疗方法。
