Maker A P, Keersmaekers G H, Vanderheyden J S, Hänsch C
Department of Obstetrics and Gynecology, Sint-Augustinus Hospital, Antwerp, Belgium.
Eur J Obstet Gynecol Reprod Biol. 1993 Dec 30;52(3):187-91. doi: 10.1016/0028-2243(93)90070-s.
A total of 25 consecutive patients who had undergone a tubal sterilization and who were referred for a hysterectomy, were examined by a peroperative methylene blue test of the tubal stumps, and extensive microscopic examination of the uterine wall, cornua and tubal stumps. Eighteen patients had been sterilized by electrocoagulation and 7 by mechanical methods (clips or rings). Tubo- or uteroperitoneal fistulas and endosalpingoblastosis were only observed in the group of patients sterilized by electrocoagulation. The development of tubo- or uteroperitoneal fistulas was correlated with the presence of endosalpingoblastosis and of uterine adenomyosis (P = 0.002 and P = 0.038, respectively). All patients with bilateral fistulas had bilateral endosalpingoblastosis and the only patient with a unilateral fistula had endosalpingoblastosis on the same side. The development of endosalpingoblastosis in patients sterilized by electrocoagulation was correlated with the presence of uterine adenomyosis (P = 0.008). In the same group of patients, a correlation between the length of the proximal tubal stump and the development of utero- or tuboperitoneal fistulas was observed (Wilcoxon test, P = 0.033). Two patients developed an ectopic pregnancy following sterilization. Both patients were sterilized by electrocoagulation, and had endosalpingoblastosis and bilateral fistulas. Our results suggest that the presence of uterine adenomyosis might predispose to the development of endosalpingoblastosis when performing tubal electrocoagulation close to the uterine cornum. We therefore suggest that when performing tubal coagulation, the intact proximal stump should be at least 2 cm.
共有25例连续接受输卵管绝育术并因子宫切除术前来就诊的患者，接受了输卵管残端术中亚甲蓝试验以及子宫壁、子宫角和输卵管残端的广泛显微镜检查。18例患者通过电凝绝育，7例通过机械方法（夹子或环）绝育。仅在电凝绝育的患者组中观察到输卵管或子宫腹膜瘘以及输卵管胚细胞瘤。输卵管或子宫腹膜瘘的发生与输卵管胚细胞瘤和子宫腺肌病的存在相关（分别为P = 0.002和P = 0.038）。所有双侧瘘患者均有双侧输卵管胚细胞瘤，唯一的单侧瘘患者在同侧有输卵管胚细胞瘤。电凝绝育患者中输卵管胚细胞瘤的发生与子宫腺肌病的存在相关（P = 0.008）。在同一组患者中，观察到近端输卵管残端长度与子宫或输卵管腹膜瘘的发生之间存在相关性（Wilcoxon检验，P = 0.033）。两名患者绝育后发生异位妊娠。两名患者均通过电凝绝育，并患有输卵管胚细胞瘤和双侧瘘。我们的结果表明，当在子宫角附近进行输卵管电凝时，子宫腺肌病的存在可能易导致输卵管胚细胞瘤的发生。因此，我们建议在进行输卵管电凝时，完整的近端残端应至少2厘米。
