Barbot J, Dubuisson J B, Henrion R
J Gynecol Obstet Biol Reprod (Paris). 1982;11(3):417-21.
One of the difficulties in tubal surgery concerning the distal portion of the tube is the accurate assessment of the value of the ampullary muscularis and mucosa on which depend the choice of the right operative procedure and the prognosis. The difficulties are most important in case of total terminal occlusion particularly when the site of the former ostium is no longer visible. An exploratory salpingotomy preceding any repair is made under the operating microscope. The simple technique that we describe allows: --an accurate assessment of the inner ampulla; --lysis of the mucosal adhesions inside the ampulla; --detection of the former ostium from the inside and the incision in the right place. The functional consequences of such an incision are difficult to appraise because the number of cases is so far too small and the follow up too short. However, those consequences seem slight when compared to the advantages, which are better precision in the investigation, the indication and the execution of the surgical repair.
输卵管远端手术的难点之一在于准确评估壶腹部肌层和黏膜的状况,这关系到正确手术方式的选择及预后。在完全末端阻塞的情况下,尤其是原输卵管开口部位已不可见时,这些困难最为突出。在进行任何修复手术之前,需在手术显微镜下做探查性输卵管切开术。我们所描述的简单技术能够:——准确评估壶腹部内部情况;——松解壶腹部内的黏膜粘连;——从内部找到原输卵管开口并在正确位置进行切开。由于目前病例数量过少且随访时间过短,这种切开的功能后果难以评估。然而,与优势相比,这些后果似乎微不足道,优势在于手术探查、手术指征及手术修复的实施更加精确。