Laparoscopic non-microsurgical tubal reanastomosis: A retrospective cohort study

Abstract Objective To determine the pregnancy rate achieved through laparoscopic tubal reanastomosis using only standard 5 mm laparoscopic instruments and standard suturing material. Methods Data from 100 consecutive laparoscopic tubal reanastomosis procedures done between September 2002 and September 2010 were retrospectively analysed. All procedures were performed by the same surgeon using standard 5 mm laparoscopic instruments and with the placing of three or four sutures of standard polyglycan 4/0 suturing material. The main outcome measures were: (intrauterine) pregnancy rate and live birth rate before and after 40 years of age, and tubal patency rate. Results Six patients had no active child wish and six others were lost to follow-up, thus leaving 88 of 100 patients for evaluation. Fifty-eight of these conceived, giving a total pregnancy rate (PR) of 66%. The PR in women younger than 40 years was significantly greater than that achieved by those aged 40 or more (73% vs. 29%, p = 0.001). Conclusions Laparoscopic tubal reanastomosis with standard 5 mm laparoscopic instruments results in a satisfactory pregnancy rate. Chinese Abstract 摘要： 目的 测定那些仅采用标准5毫米腹腔镜的手术器械及标准缝合材料进行输卵管复通术的患者的受孕率。方法 本研究对2002年9月至2010年9月之间进行输卵管复通术的患者进行了回顾性的分析。所有患者均由相同的外科医师采用标准的5毫米腹腔镜手术器械，并且采用三至四个4/0标准多聚糖缝合线。主要结果评定:40岁左右患者(宫内)妊娠率和活产率,以及输卵管通畅程度。结果 在100位患者中，有6例患者没有妊娠的意愿,6位患者失访,因此我们对剩余的88位患者进行了评估。其中58位患者妊娠，总妊娠率为66%。40岁以下的年轻女性的受孕率明显高于那些40岁以上的女性（73%比29%，P<0.001）结论 采用5毫米标准腹腔镜手术器械进行的腹腔镜下输卵管复通术可以取得满意的妊娠效果。