Eyraud B, Erny R, Vergnet F
C.P.M.A., Hôpital de La Conception, Marseille.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(1):9-14.
Between January 1987 and May 1990, forty-four women were treated in our department by laparoscopic surgery for distal tubal pathology. Among them, 10 had an intrauterine pregnancy (22.7%) and 2 had an ectopic pregnancy (4.5%) within 28 months after surgery. Subsequently, our results were expressed in terms of the type of operation performed (fimbrioplasty or neosalpingostomy) and according to the tubal and adhesion scores (Mage and Bruhat). We found that most pregnancies were obtained within the first 16 months, that fimbrioplasty gave better results than neosalpingostomy (35.7% versus 16.6%) and that the tubal score was fairly predictive and more so than the adhesion score. These results enabled us to keep as indication of distal tubal laparoscopic surgery those patients who had pure distal tubal lesions with a tubal core of 1 to 2 and normal other parameters of infertility. In case of failure, i.e. if the woman does not become pregnant within 12 months post-laparoscopic surgery, in vitro fertilization is advised.
1987年1月至1990年5月期间，我院对44例因远端输卵管病变接受腹腔镜手术的女性进行了治疗。其中，10例在术后28个月内发生宫内妊娠（22.7%），2例发生异位妊娠（4.5%）。随后，我们根据所施行的手术类型（输卵管伞成形术或输卵管新造口术）以及输卵管和粘连评分（ Mage和Bruhat评分）来表述结果。我们发现，大多数妊娠发生在术后16个月内，输卵管伞成形术的效果优于输卵管新造口术（35.7%对16.6%），并且输卵管评分具有较好的预测性，比粘连评分更具预测性。这些结果使我们将单纯远端输卵管病变、输卵管核心评分为1至2分且其他不孕参数正常的患者作为远端输卵管腹腔镜手术的适应证。若手术失败，即女性在腹腔镜手术后12个月内未怀孕，则建议进行体外受精。
