Fernandez H, Marchal L, Vincent Y
Department of Obstetrics and Gynecology, Antoine Béclère Hospital, Clamart, France.
Fertil Steril. 1998 Oct;70(4):680-6. doi: 10.1016/s0015-0282(98)00251-9.
To evaluate fertility after salpingectomy performed for ectopic pregnancies (EPs).
Retrospective cohort study.
Tertiary care university hospital.
PATIENT(S): Three hundred forty patients (213 with surgery by laparoscopy and 127 by laparotomy) between January 1985 and July 1994, with a mean follow-up period of 73 months (36-162 months).
INTERVENTION(S): Salpingectomy performed either by laparotomy or by laparoscopy as indicated.
MAIN OUTCOME MEASURE(S): Rate of intrauterine pregnancy (IUP), live births, and recurrent EP.
RESULT(S): Forty-seven (13.8%) patients were lost to follow-up, and 68 (20%) did not want to become pregnant. The overall rate of spontaneous conception was 70.4% in the laparoscopy group and 53.2% in the laparotomy group. The rate of live births was 50% and 37%, respectively; the mean time until conception was 11 and 17.2 months; and the rate of recurrent EP, 10.6% and 9.6%. The multivariate analysis showed a rate of IUP of 82.1% among women younger than 30 years of age with a normal contralateral tube, laparoscopic surgery, and no history of infertility.
In this study of fertility after salpingectomy for EP, laparoscopic treatment was superior to laparotomic treatment. Fertility was equivalent to that after conservative treatment in a subgroup of young patients treated with laparoscopy and with no history of tubal pathology.
评估因异位妊娠（EP）行输卵管切除术后的生育能力。
回顾性队列研究。
三级医疗大学医院。
1985年1月至1994年7月期间的340例患者（213例行腹腔镜手术，127例行剖腹手术），平均随访期73个月（36 - 162个月）。
根据情况行剖腹手术或腹腔镜手术切除输卵管。
宫内妊娠（IUP）率、活产率和复发性EP。
47例（13.8%）患者失访，68例（20%）患者不想怀孕。腹腔镜组自然受孕总率为70.4%，剖腹手术组为53.2%。活产率分别为50%和37%；受孕平均时间分别为11个月和17.2个月；复发性EP率分别为10.6%和9.6%。多因素分析显示，年龄小于30岁、对侧输卵管正常、行腹腔镜手术且无不孕史的女性IUP率为82.1%。
在这项关于EP输卵管切除术后生育能力的研究中，腹腔镜治疗优于剖腹手术治疗。在接受腹腔镜手术且无输卵管病变史的年轻患者亚组中，生育能力与保守治疗后的生育能力相当。
