Gomel V
Fertil Steril. 1977 Jan;28(1):59-65.
The enormous increase in the number of sterilizations performed in young women is creating a demand for reversal of this procedure. The author's experience with tubal reanastomosis using a microsurgical technique is presented. The traditional approach to cornual occlusion of the tubes has been tubouterine implantation. The demonstration that in such cases the intramural portion of the tube is often patent and that the occlusion site is located in the proximal isthmus has allowed, instead, resection and end-to-end anastomosis at the cornua. Including both tubouterine anastomosis for cornual occlusion and end-to-end anastomosis after previous sterilization, tubal reanastomosis was performed in 31 patients. The postoperative patency rate was 87%, and 64% have had intrauterine pregnancies. In the group subjected to tubal reanastomosis following a previous sterilization, 72.7% of those attempting a pregnancy and having more than 6 months' follow-up have had intrauterine gestations.
年轻女性绝育手术数量的大幅增加引发了对该手术进行逆转的需求。本文介绍了作者使用显微外科技术进行输卵管再吻合术的经验。传统的输卵管子宫角阻塞方法是输卵管子宫植入术。然而，研究表明，在这类病例中，输卵管壁内部份通常是通畅的，阻塞部位位于近端峡部，因此可以改为在子宫角处进行切除并端端吻合。包括针对子宫角阻塞的输卵管子宫吻合术以及先前绝育术后的端端吻合术，共对31例患者进行了输卵管再吻合术。术后通畅率为87%，64%的患者发生了宫内妊娠。在先前绝育后接受输卵管再吻合术的组中，尝试妊娠且随访超过6个月的患者中有72.7%发生了宫内妊娠。
