DeCherney A H, Kase N
Fertil Steril. 1981 Feb;35(2):162-6. doi: 10.1016/s0015-0282(16)45316-1.
Eighteen patients with bilateral tubal occlusion were divided in an alternating fashion just prior to surgery into two groups for definitive treatment. One group consisted of nine women who underwent a two-stage procedure utilizing a Rock-Mulligan prosthesis; the other nine women underwent terminal salpingostomy utilizing microsurgical technique. Microsurgical technique was defined as the use of microcautery, lavage, and careful handling of tissues; the operating microscope was employed to achieve better visualization and hence better hemostasis and minimized tissue trauma. Both groups received pre-, intra-, and postoperative antibiotics, Decadron, and Phenergan. Hysterosalpingography revealed a patency rate of 89% in the hood group and in the group in which microsurgical technique was used. The term intrauterine pregnancy rates were 22.2% in the hood group (two of nine) and 44.4% in the group in which microsurgical technique was used (four of nine). In this small series there were no ectopic pregnancies or early pregnancy wastage. Subsequently, a series of 54 patients was treated by terminal salpingostomy with an over-all term intrauterine pregnancy rate of 26%. From this study, we conclude that the use of Rock-Mulligan hoods offers no distinct advantage over microsurgical salpingostomy, but has the disadvantage of requiring two surgical procedures.
18例双侧输卵管阻塞患者在手术前被交替分为两组进行确定性治疗。一组由9名女性组成，她们接受了使用Rock-Mulligan假体的两阶段手术；另外9名女性采用显微外科技术进行了输卵管末端造口术。显微外科技术的定义为使用微型电烙器、灌洗以及小心处理组织；使用手术显微镜以实现更好的视野，从而实现更好的止血并将组织创伤降至最低。两组患者均在术前、术中和术后接受了抗生素、地塞米松和非那根治疗。子宫输卵管造影显示，使用Rock-Mulligan假体组和使用显微外科技术组的通畅率均为89%。使用Rock-Mulligan假体组的宫内妊娠率为22.2%（9例中的2例），使用显微外科技术组的宫内妊娠率为44.4%（9例中的4例）。在这个小样本系列中，没有宫外孕或早期妊娠丢失的情况。随后，54例患者接受了输卵管末端造口术治疗，总体宫内妊娠率为26%。从这项研究中，我们得出结论，使用Rock-Mulligan假体相对于显微外科输卵管造口术没有明显优势，但有需要进行两次外科手术的缺点。
