腹腔镜下输卵管伞部成形术235例报告

Plastic operation of salpingian fimbria under video laparoscope:report of 235 cases

目的 :对 2 35例输卵管积水患者行电视腹腔镜输卵管造口袖口外翻伞部成形术 ,探讨手术操作要点及影响手术成功的相关因素。方法 :对 2 35例诊断为单侧或双侧输卵管积水不孕症患者 ,在电视腹腔镜下行卵管造口浆膜面点状电凝袖口外翻伞部成形术。结果 :伞部造口外翻成形率 98.5 1%。镜下诊断严重盆腔粘连 5 3.6 % (12 6 / 2 35 ) ;轻度粘连 35 .32 % (83/2 35 ) ;输卵管积水直径大于 3cm16 .17% (38/ 2 35 ) ;合并盆腔除粘连以外的其他疾病占 31.9% (75 / 2 35 ) ;术后随访率 90 .6 4%(2 13/ 2 35 ) ;术后宫内妊娠率 2 1.6 % (46 / 2 13)。其中双侧输卵管积水患者术后宫内妊娠率 16 .45 % (2 5 / 15 2 ) ,单侧妊娠率34 .43% (2 1/ 6 1) ;无或轻度盆腔粘连患者术后宫内妊娠率 31.5 3% (2 6 / 111) ,重度粘连妊娠率 10 .78% (11/ 10 2 )。结论 :腹腔镜手术是治疗输卵管积水的一种有效的方法 ,浆膜面点状电凝袖口外翻有其独特的优点 ,是值得推荐的手术方法。

Objective:To evaluate the effect of plastic operation of salpingian fimbria under video abdominoscopy Method:235 patients with infertility due to unilateral or bilateral hydrosalpinx received plastic operation of cuff extrophia in fimbria after completing spot electrocoagulation to seromenbranous superficies Result:The rate of successful shape was 98 51% The percentage of heavy adhesion was 53 3%(126/235) and the light was 35 32%(83/235) Of them those diameter of hydrops tubes more than 3cm were 16 17%(38/235),and other diseases in pelvic cavity apart from adhesion accounted for 31 9%(75/235) After operation,90 64%(213/235) were followed up and 21 6%(46/213) normal pregnant Among them,16 45%(25/152) were bilateral suffering and 34 43%(21/61) were unilateral The successful rate in the non adhesion or light was 31 53%(26/111) and in the heavy was 10 78%(11/102) Conclusion:Operation under video abdominoscopy is effective treatment for hydrosalpinx