Hovsepian D M, Bonn J, Eschelman D J, Shapiro M J, Sullivan K L, Gardiner G A
Division of Cardiovascular and Interventional Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa.
Radiology. 1994 Jan;190(1):137-40. doi: 10.1148/radiology.190.1.8259391.
To review the effectiveness of fallopian tube recanalization (FTR) when performed without restriction based on history or tubal condition.
From October 1989 to July 1992 in 37 consecutive women, aged 22-44 years (mean, 35 years), 42 FTRs were performed (five patients each underwent two FTRs). Water-soluble contrast material and selective ostial salpingography and/or microcatheter technique were used exclusively. Eighty tubes were evaluated, since four patients had previously undergone unilateral salpingectomy. Sixty-three tubes (79%) were occluded at the outset of the procedure.
Complete recanalization was achieved in 45 of 63 (71%) occlusions. Adhesions were present in 25 of 80 (31%) tubes, salpingitis isthmica nodosa in 12 (15%), and hydrosalpinx in nine (11%). The 42 procedures resulted in 14 (33%) conceptions, nine (64%) of which involved pathologic tubes. Eleven intrauterine pregnancies resulted in five spontaneous first-trimester abortions, five full-term deliveries, and one continuing pregnancy.
Favorable conception and live birth rates can be achieved with FTR, despite a high prevalence of tubal disease.
回顾在不基于病史或输卵管状况进行限制的情况下进行输卵管再通术(FTR)的有效性。
1989年10月至1992年7月,对37例年龄在22 - 44岁(平均35岁)的连续女性进行了42次FTR(5例患者每人接受了两次FTR)。仅使用水溶性造影剂以及选择性输卵管口造影和/或微导管技术。由于4例患者先前接受过单侧输卵管切除术,因此对80条输卵管进行了评估。在手术开始时,63条输卵管(79%)堵塞。
63处堵塞中有45处(71%)实现了完全再通。80条输卵管中有25条(31%)存在粘连,12条(15%)存在结节性输卵管峡部炎,9条(11%)存在输卵管积水。42次手术导致14例(33%)受孕,其中9例(64%)涉及病变输卵管。11例宫内妊娠导致5例孕早期自然流产、5例足月分娩和例持续妊娠。
尽管输卵管疾病的患病率很高,但FTR仍可实现良好的受孕率和活产率。