Background: Salpingostomy for ectopic pregnancy in patients who has aspirations to having a baby is a necessity. Objective: To discover the factors affecting the outcome of salpingostomy. Subjects and method: 400 patients with none or one baby treated by salpingectomy or salpingostomy for ectopic pregnancy in National Hospital of Obstetrics and Gynecology from July 2006 to June 2007 were studied. The data was analyzed with T test and logistic regression. Results: 92 of 400 patients (23%) were treated by salpingostomy. The risk of salpingectomy for patients with size of pregnancy mass >2 cm (measured by ultrasound) was 2.48 times higher than that of mass <=2 cm (95% CI: 1.50-4.12). All of cases with positive fetal heart beat were treated by salpingectomy. The danger of salpingectomy for patients with preoperative level of bhCG >3000 UI/L increased by 6.65 fold in comparison with that of bhCG <=3000 UI/L (95% CI: 2.99-15.27). The risk of salpingostomy for patients with the size of pregnancy mass >3 cm is 7.43 times as much as that of mass <=3 cm (95% CI: 3.89-14.39). Conclusion: The chance of salpingostomy for patients having the size of pregnancy mass <=3 cm and bhCG <=3000 UI/L was 24.1%.
Ectopic pregnancy ; salpingostomy

No abstract available.
Fallopian Tubes* ; Female ; Pregnancy* ; Pregnancy, Tubal* ; Salpingostomy*

OBJECTIVE: This study investigates the morbidity of adnexal surgery through minilapatotomy by comparing with adnexal surgery through laparotomy. METHODS: From January 2000 to December 2001, 84 patients with adnexal diseases were managed through minilaparotomy and 80 patients treated with adnexal surgery through laparotomy. RESULTS: Fifty-three (69.0%) of the adnexal diseases were ectopic pregnancies. Fifty-seven patients (67.9%) were treated with salpingectomy. Other patients were treated with the following operations: salpingotomy (3 cases, 3.6%); salpingostomy (3 cases, 3.6%); fimbrioplasty (2 case, 2.4%); ovarian cyst enucleation (4 cases, 4.8%); ovarian resection (6 cases, 7.1%); parovarian cystectomy (5 cases, 6.0%); salpingooophorectomy (4 case, 4.8%). The average operation time for minilaparotomy was 30.5 +/- 9.2 minutes. The average bowel function recovery time for minilaparotomy was 28.2 +/- 15.6 hours (p<0.05). The average postoperative pain control was 29 cases (34.5%) lower than that of controls (p<0.05). The average postoperative hospital stay for minilaparotomy was 3.4 +/- 1.0 days (p<0.05). The procedure morbidity was lower than that of controls. CONCLUSION: It is suggested that minilaparotomy is a quick, convenient method to decrease patient morbidity and postoperative stay and that it could be considered an alternative to laparotomy for the treatment of adnexal diseases.
Adnexal Diseases ; Cystectomy ; Female ; Humans ; Laparotomy* ; Length of Stay ; Ovarian Cysts ; Pain, Postoperative ; Pregnancy ; Pregnancy, Ectopic ; Recovery of Function ; Salpingectomy ; Salpingostomy

Adult ; Female ; Humans ; Laparoscopy ; Pelvic Inflammatory Disease ; etiology ; microbiology ; Pneumococcal Infections ; etiology ; Postoperative Complications ; Salpingostomy ; Smoking ; adverse effects ; Streptococcus pneumoniae

OBJECTIVE: To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. METHODS: This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates. RESULTS: Of the 57 surgical procedures, 55 (96.4%) were performed successfully without any additional intervention. The number of patients receiving salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking were 24 (42.1%), 25 (43.9%), 4 (7.0%), and 2 (3.5%), respectively. Two case was switched to salpingectomy because excessive bipolar coagulation was required to obtain hemostasis at the tubal bleeding bed. Over a mean β-human chorionic gonadotropin resolution time of 18.3±5.9 days, no persistent trophoblast or postoperative complications occurred. A tubal patency test using hysterosalpingography was performed in 15 cases at 3 months postoperatively. Among these, the homolateral tubal patency rate was 75% (11 of 15) and the contralateral patency rate was 80% (12 of 15). CONCLUSION: Tube-preserving surgery is a feasible and safe treatment option for ectopic tubal pregnancy. However, considering that the optimal goal of tube-preserving surgical procedures is not the treatment success, some caution is warranted in interpreting results of this study.
Chorionic Gonadotropin ; Female ; Hemorrhage ; Hemostasis ; Humans ; Hysterosalpingography ; Milk ; Outcome Assessment (Health Care) ; Postoperative Complications ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Prospective Studies ; Salpingectomy ; Salpingostomy ; Trophoblasts

Tubal and peritoneal factors account for 30% to 40% of cases of female infertility. Tubal factors include damage or obstruction of the fallopian tube. The best technique for diagnosing tubal and peritoneal disease is laparoscopy, and laparoscopic surgery has been used to various tubal conditions (such as laparoscopic fimbrioplasty, salpingectomy, salpingostomy, and tubal reversal). Approximately 1% of the women who undergo tubal sterilization subsequently request reversal of tubal sterilization. Two treatment options are available to women who wished to become pregnant after having tubal sterilization: tubal reversal or in vitro fertilization (IVF). Laparoscopic tubal reversal shows high pregnancy rates similar to laparotomy and superior to the rates reported for IVF. Hydrosalpinx is a common tubal disease that is associated with lower implantation and pregnancy rates. The proper selection of patients for surgical treatment and of the type of surgical technique are essential to achieve good results. For patients with mild tubal disease, good results can be achieved by an experienced surgeon; however, for patients with severe tubal disease, the prognosis of surgery is poor. In these cases, In-vitro fertilization (IVF) is the main line of treatment for infertility caused by hydrosalpinx.
Fallopian Tubes ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility ; Infertility, Female ; Laparoscopy ; Laparotomy ; Peritoneal Diseases ; Pregnancy Rate ; Prognosis ; Salpingectomy ; Salpingostomy ; Sterilization, Tubal

OBJECTIVETo compare the effect of treatment of fallopian tube obstructive infertility by salpingostomy alone and in combination with TCM drugs for Bushen Huoxue (invigorating Shen and promoting blood circulation).

METHODSTo all the patients, salpingostomy was performed 3 to 7 days after menstruation and hydrotubation with Xiangdan Injection (XI) was applied once in the next menstrual cycle. Bushen Huoxue Decoction (BHD) was administrated additionally to patients in the treated group, 1 dose every day starting from the 5th day of menstrual cycle for 14 days. Three months' treatment was taken as one therapeutic course and the observation lasted for 4 courses.

RESULTSThe condition of follicular development, thickness of endometrium and level of serum estradiol in the preovulatory phase after treatment were all significantly increased in the two groups (P < 0.05 and P < 0.01); but the improvement in the treated group was significantly superior to that in the control group, showing significant difference. Moreover, the pregnancy rate was also higher in the former than in the latter (P < 0.05).

CONCLUSIONThe combined therapy of salpingostomy and TCM drugs for invigorating Shen and promoting blood circulation is an effective therapy for fallopian tube obstructive infertility, it has the effect of enhancing follicular development and increasing thickness of endometrium, and could elevate the pregnancy rate in patients.

Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Fallopian Tube Diseases ; complications ; therapy ; Female ; Humans ; Infertility, Female ; etiology ; therapy ; Medicine, Chinese Traditional ; Phytotherapy ; Salpingostomy ; Treatment Outcome

The objective of this study was to evaluate the feasibility of posterior colpotomy for the surgical treatment of tubal ectopic pregnancy in hemodynamically stable women. We performed a retrospective analysis of medical records obtained over a period of 18 months. Twelve cases were identified, with the following characteristics: mean gestational age, 7.7 weeks; mean serum β-human chorionic gonadotropin level, 7,786 mIU/mL; and greater diameter of the mass, 15–69 mm. Treatment was successful in all cases. Salpingectomy was performed in 10 patients (83.3%) and salpingostomy, in 1 patient. The remaining patient only received peritoneal lavage, as the evidence of ectopic abortion with only a slightly dilated uterine tube was found during surgery. The mean surgical time was 42.5 minutes. In the analyzed cases, posterior colpotomy was found to be a feasible alternative method for the surgical treatment of tubal ectopic pregnancy in hemodynamically stable women.
Chorionic Gonadotropin ; Colpotomy ; Fallopian Tubes ; Female ; Gestational Age ; Humans ; Medical Records ; Methods ; Operative Time ; Peritoneal Lavage ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Retrospective Studies ; Salpingectomy ; Salpingostomy ; Surgical Procedures, Operative