Oelsner G, Rabinovitch O, Morad J, Mashiach S, Serr D M
J Reprod Med. 1986 Jun;31(6):483-6.
Whether restoration of tubal function following conservative surgery for ectopic pregnancy was achieved can only be estimated in patients with a single tube. Between 1978 and 1983, 22 women with a tubal pregnancy in their single tube underwent conservative microsurgical treatment. In 18 women dorsal salpingotomy was performed, in 3 the tube was gently milked (squeezing the products of conception through the fimbria), and in 1 the segment containing the products of conception was excised and the tube anastomosed. Twenty-one patients desired pregnancy. The mean follow-up period was 21.4 months. Of the patients desiring pregnancy, 76% conceived. The intrauterine pregnancy rate was 47.6%, and the repeat ectopic pregnancy rate was 42.8%. This ectopic pregnancy rate was significantly higher than those quoted in recent literature. Although the study group was a very-high-risk group, restoration of tubal function was achieved in a high proportion of cases. The intrauterine pregnancy rate was high and higher than the best results available with in vitro fertilization and embryo transfer, which is the only treatment available after bilateral salpingectomy. Therefore, conservative surgery is definitely indicated in such patients despite the high incidence of repeat ectopic pregnancy.
对于单输卵管的异位妊娠患者，只能评估保守手术后输卵管功能是否恢复。1978年至1983年期间，22名单侧输卵管妊娠的女性接受了保守性显微手术治疗。18名女性进行了输卵管背侧切开术，3名女性对输卵管进行了轻柔挤捏（将妊娠产物通过伞端挤出），1名女性切除了含有妊娠产物的节段并进行了输卵管吻合术。21名患者渴望怀孕。平均随访期为21.4个月。在渴望怀孕的患者中，76%成功受孕。宫内妊娠率为47.6%，重复异位妊娠率为42.8%。这一异位妊娠率显著高于近期文献报道的比率。尽管研究组是一个极高风险组，但在很大比例的病例中输卵管功能得以恢复。宫内妊娠率很高，且高于双侧输卵管切除术后唯一可用的治疗方法——体外受精和胚胎移植的最佳结果。因此，尽管重复异位妊娠的发生率很高，但对于此类患者，保守手术绝对是必要的。
