Das K, Nagel T C, Malo J W
Reproductive Health Associates, St. Paul, Minnesota, USA.
Fertil Steril. 1995 May;63(5):1009-15.
To compare overall the results of hysteroscopic tubal cannulations and resection anastomosis for proximal tubal occlusion.
Nonrandomized retrospective analysis of patients operated on by two surgeons.
University and large tertiary referral private practice.
Seventy-four patients over a 10-year period, with bilateral or unilateral proximal occlusion of a single tube.
Hysteroscopic cannulation, resection anastomosis, or both.
Intrauterine and ectopic pregnancy rates, long-term tubal patency, and pathology of tubal segments.
In patients with normal distal tubes, intrauterine pregnancy rates were similar (12/21, 57% versus 12/24, 50%) and ectopic pregnancy rates were lower (0/21, 0% versus 7/24, 29.1%) in the cannulation group. One-year patency rates in nonpregnant patients was higher in the anastomosis group (12/15, 80% versus 3/8, 33%).
Hysteroscopic cannulation should be first choice in the management of proximal tubal obstructions in selected patients. It may be a treatment option for delayed occlusion after successful cannulation or resection anastomosis.
全面比较宫腔镜输卵管插管术与近端输卵管阻塞切除吻合术的效果。
对两位外科医生手术治疗的患者进行非随机回顾性分析。
大学及大型三级转诊私人诊所。
10年间74例患者，单根输卵管双侧或单侧近端阻塞。
宫腔镜插管术、切除吻合术或两者皆用。
宫内妊娠率和异位妊娠率、输卵管长期通畅情况以及输卵管段病理。
在远端输卵管正常的患者中，插管组的宫内妊娠率相似（21例中有12例，57% 对比24例中有12例，50%），而异位妊娠率较低（21例中0例，0% 对比24例中有7例，29.1%）。吻合组非妊娠患者的一年通畅率较高（15例中有12例，80% 对比8例中有3例，33%）。
宫腔镜插管术应作为特定患者近端输卵管阻塞治疗的首选方法。对于插管或切除吻合术成功后出现的延迟阻塞，它可能是一种治疗选择。
