腹腔镜输卵管吻合术:附32例临床分析

目的评价腹腔镜输卵管吻合术的输卵管通畅率及妊娠结局。方法对32位输卵管堵塞的患者行腹腔镜下显微输卵管吻合术并统计妊娠率（PR），以及影响妊娠结局的因素。结果32例中，术后通畅率为90.2%（55/61），术后宫内妊娠率为50.0%（16/32），无1例宫外孕发生。累积妊娠率，术后6个月为15.6%，12个月为43.8%，18个月为50.0%。96%的妊娠发生在术后一年内。峡部～峡部吻合妊娠率（55.0%）高于壶腹部～壶腹部妊娠率（41.7%）但无统计学差异。大于40岁患者妊娠率为（0/3），小于40岁患者妊娠率为55.2%（16/29）。结论腹腔镜输卵管吻合术具有较高成功率，是输卵管堵塞患者的一个较好的治疗选择。

Laparoscopic tubal anastomosis: fertility outcome in 32 cases

Objective To evaluate the pregnancy rate and tubal patent rate after laparoscopic tubal anastomosis.Methods Laparoscopic tubal anastomosis was performed on thirty~two women who desired reversal of tubal occlusion.Calculate the cumulative pregnancy rate(PR)and investigate factors that influenced the pregnancy outcome.Results The tubal patent rate after operation is 90.2%(55/61),the intrauterine PR was 50.0%(16/32),without ectopic pregnancies.The cumulative PR in the 32 patients for whom follow~up data were available was 15.6%,43.8%,and 50.0% at 6,12,and 18 months after operation,respectively.96% intrauterine pregnancy occurred during the first year after the operation.The intrauterine PR for isthmic-isthmic anastomosis(55.0%)was higher than that for ampullar-ampullar anastomosis(41.7%),but there was no significant difference.The PR decreased with the patients' age,it was 0(0/3)in the patients older than 40 years and 55.2(16/29)in the patients younger than 40 years.Conclusions Laparoscopic tubal anastomosis is a highly successful procedure with a shorter recovery time.It could be considered a better choice in patients who desire reversal of tubal occlusion.