Lang E K, Dunaway H H
Department of Radiology, Louisiana State University Medical Center, New Orleans 70112.
Radiology. 1994 May;191(2):507-12. doi: 10.1148/radiology.191.2.8153330.
To evaluate use of transcervical recanalization in patients with reocclusion of the proximal fallopian tube after failed surgery to reverse sterilization or failed tuboplasty to treat inflammatory disease.
The standard technique for transcervical recanalization was attempted in seven patients after failed reversal surgery and in 12 after failed tuboplasty. Four of seven patients with failed reversal surgery had fistular tracts and one also had a stricture; the remaining three patients and all 12 patients treated after failed tuboplasty and tube reimplantation had strictures at the site of implantation or anastomosis.
Transcervical recanalization failed in all patients with fistulas but succeeded in 13 of 15 with stenoses. Three patients became pregnant 1-16 months after recanalization and two after in vitro fertilization and embryo transfer. Reocclusion occurred in two of 10 patients reexamined 6-36 months after recanalization.
Transcervical recanalization is recommended as an alternative to repeat microsurgical reimplantation or tuboplasty.
评估在绝育术逆转失败或输卵管成形术治疗炎性疾病失败后近端输卵管再闭塞患者中经宫颈再通术的应用。
对7例逆转手术失败患者和12例输卵管成形术失败患者尝试采用经宫颈再通术的标准技术。7例逆转手术失败患者中有4例存在瘘管，1例还伴有狭窄；其余3例患者以及所有12例输卵管成形术和输卵管再植术失败后接受治疗的患者在植入或吻合部位均有狭窄。
所有有瘘管的患者经宫颈再通术均失败，但15例有狭窄的患者中有13例成功。3例患者在再通术后1 - 16个月怀孕，2例在体外受精和胚胎移植后怀孕。再通术后6 - 36个月复查的10例患者中有2例再次闭塞。
推荐经宫颈再通术作为重复显微外科再植术或输卵管成形术的替代方法。
