Clinical effect of Laparoscopic partial resection of the fallopian tube and end-to-end anastomosis for the treatment of recurrent tubal pregnancy
JIANG Xiao-lan1 KANG Jia-li1 ZHANG Xiao-yan1 TANG Wei1 CHEN Yan-mei1 GONG Yan-mei2
1. Department of Gynecology and Obstetrics，Guangzhou First People′s Hospital，Guangdong Province，Guangzhou 511457，China；
2. Department of Ultrasound，Guangzhou First People′s Hospital，Guangdong Province，Guangzhou 511457，China
Abstract：Objective To study the efficacy and pregnancy outcome of laparoscopic partial fallopianectomy and endto-end anastomosis for recurrent tubal pregnancy. Methods A total of 60 patients with ampulla or isthmus pregnancy who were admitted to our hospital from January 2014 to December 2018 were selected as the research objects. They were divided into observation group and control group according to the principle of random grouping. The observation group was treated with laparoscopic partial salpingectomy and end-to-end anastomosis，and the control group was treated with laparoscopic tubal pregnancy removal (including fenestration and incision embryo suture). Surgical time，intraoperative blood loss，postoperative hospitalization time，postoperative decrease in human choionic gonadotophin(HCG)，incidence of persistent ectopic pregnancy，and incidence of tubal on the affected side Unobstructed condition(uterine fallopian tube angiography) and postoperative intrauterine pregnancy rate were compared between two groups.Results The operation time was (74.5±5.3) d in the observation group，longer than that in the control group for (53.5±4.7) d，and the difference was statistically significant (P＜0.05)； the intraoperative blood loss was (25.6±5.2) ml and postoperative hospital stay was (4.0±2.9) d in the observation group，compared with the control group for (30.1±4.8) ml，(4.0±3.7) d，the differences were not statistically significant (P＞0.05)； the blood HCG in patients in the observation group decreased 3 d and 2 weeks after surgery was (82.5±5.4)，(91.2±2.7) mIU/ml，which was higher than that in the control group for (65.5±4.8)，(98.4±1.6) mIU/ml，the differences were statistically significant (P＜0.05)； the incidence of persistent ectopic pregnancy in the observation group was (0.00%) lower than that of the control group (10.00%)，the difference was statistically significant (P＜0.05).The tubal patency of the observation group was better than that of the control group，and the rate of intrauterine pregnancy again was higher than that of the control group，the differences were statistically significant (P＜0.05). Conclusion Laparoscopic partial fallopian tube resection and end-to-end anastomosis for the treatment of recurrent tubal pregnancy can reduce the incidence of persistent ectopic pregnancy，improve the intrauterine pregnancy rate after surgery，thereby reducing the damage caused by assisted reproduction to the patient′s body and reducing the patient′s economy.
Mol F，van Mello NM，Strandell A，et al.Cost-effectiveness of salpingotomy and salpingectomy in women with tubal pregnancy （a randomized controlled trial）［J］.Hum Reprod，2015，30（9）：2038-2047
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