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目的:探讨微型腹腔镜手术在输卵管吻合复通中的应用价值。方法:回顾性分析66例输卵管绝育术后因需生育而行吻合复通术的患者资料,将其中36例利用微型腹腔镜完成输卵管复通术者(腹腔镜组),并与同期完成的开腹下输卵管复通术30例(开腹组)作对比研究。结果:所有患者手术均顺利完成,术后随访5～ 48个月。腹腔镜组宫内妊娠27例,异位妊娠2例,未孕7例,宫内妊娠率75.00%,总妊娠率80.56%。开腹组宫内妊娠15例,异位妊娠3例,未孕12例,宫内妊娠率50.00%,总妊娠率60.00%。宫内妊娠率、总妊娠率组间差异有统计学意义(P<0.05)。合并盆腔粘连者,术后宫内妊娠率、总妊娠率组间比较,差异有统计学意义(P<0.05)。结论:与开腹手术相比,微型腹腔镜手术用于输卵管复通具有损伤小、出血少、术后恢复快、术后宫内妊娠率提高的优势,尤其适合于合并盆腔粘连的患者。
Objective: To investigate the value of mini-laparoscopic surgery in tubal anastomosis. Methods: A retrospective analysis of 66 cases of tubal sterilization after childbirth due to anastomosis and recanalization of patients, of which 36 cases of patients with minimally invasive laparoscopic tubal recanalization (laparoscopic group), and with the completion of the same period 30 cases of abdominal tubal union (open group) for comparative study. Results: All patients underwent surgery successfully. The patients were followed up for 5 to 48 months. 27 cases of intrauterine pregnancy in laparoscopic group, 2 cases of ectopic pregnancy, 7 cases of non-pregnancy, intrauterine pregnancy rate of 75.00%, the total pregnancy rate was 80.56%. 15 cases of intrauterine pregnancy in open group, ectopic pregnancy in 3 cases, 12 cases of non-pregnancy, intrauterine pregnancy rate of 50.00%, the total pregnancy rate of 60.00%. Intrauterine pregnancy rate, total pregnancy rate difference between the groups was statistically significant (P <0.05). Combined pelvic adhesions, postoperative intrauterine pregnancy rate, total pregnancy rate between the two groups, the difference was statistically significant (P <0.05). Conclusion: Compared with laparotomy, mini-laparoscopic surgery for tubal recanalization has the advantages of less injury, less bleeding, quick recovery after operation, and increased intrauterine pregnancy rate after operation, and is especially suitable for patients with pelvic adhesions.