Henderson S R
Am J Obstet Gynecol. 1981 Jan;139(1):73-9. doi: 10.1016/0002-9378(81)90415-4.
Between 1977 and 1979, 34 consecutive, unselected patients had a reversal of tubal sterilization. The characteristics of 23 patients with more than a 6-month follow-up after end-to-end anastomosis are given, as are details of the operative procedures used. The overall intrauterine pregnancy rate was 56%, and the most reversible sterilization procedures, in terms of intrauterine pregnancies, were the Pomeroy, Uchida, and Falope ring (67%). The least reversible were unipolar tubal cautery (42%) and fimbriectomy (50%). Eleven patients had a microsurgical procedure (with the microscope) and 12 a gross surgical procedure. The use of the microscope was not associated with a significantly better pregnancy rate in cases matched for poststerilization tubal length, proximal and distal to the uterus. But insufficient numbers of tubal cautery reversals have been performed for an evaluation of the use of the microscope in this particular situation. The site of the anastomosis and the postoperative length of the tube were good predictors of intrauterine pregnancies. Five of six patients who had isthmus-isthmus anastomoses on at least one side had term vaginal deliveries. Likewise, 10 of 16 patients in whom the length of the longest tube was 6 cm or more had viable pregnancies, but only one of seven patients had a viable pregnancy with tubes of 5 cm or less.
1977年至1979年间，34例连续入选且未经挑选的患者接受了输卵管绝育术的逆转手术。本文给出了23例患者在端端吻合术后随访超过6个月的特征，以及所采用手术操作的详细情况。总体宫内妊娠率为56%，就宫内妊娠而言，最易逆转的绝育手术是波默罗伊术、内田术和法洛普环扎术（67%）。最不易逆转的是单极输卵管电灼术（42%）和输卵管伞端切除术（50%）。11例患者接受了显微外科手术（使用显微镜），12例接受了大体外科手术。在根据绝育术后输卵管长度与子宫近端和远端匹配的病例中，使用显微镜与显著更高的妊娠率无关。但单极输卵管电灼术逆转手术的数量不足，无法评估在这种特殊情况下使用显微镜的效果。吻合部位和术后输卵管长度是宫内妊娠的良好预测指标。至少一侧进行峡部-峡部吻合的6例患者中有5例经阴道足月分娩。同样，最长输卵管长度为6厘米或更长的16例患者中有10例有活产妊娠，但输卵管长度为5厘米或更短的7例患者中只有1例有活产妊娠。
