Effective Method and Successful Pregnancy in Microsurgical Tubal Reanastomosis: A Report of 715 Cases

Moon, Heui Soo; Joo, Bo Sun; Park, S.J; Kim, K.S; Yoon, Joo Hee; Lee, G.W

doi:10.1016/s0015-0282(00)01312-1

Cited by 3 publications

(3 citation statements)

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“…Surgeon skill improves outcome to a great extent. It is noteworthy that in studies where it was mentioned that only one surgeon was responsible for all reanastomoses, pregnancy rates were never less than 72.5%, whether by laparotomy or laparoscopy [10,19,26,30]. Figures from the study by Kim et al [28] also showed statistical significance in the type of previous sterilization when looking at pregnancy rate as outcome.…”

Section: Discussionmentioning

confidence: 99%

“…As would be expected, pregnancy rates in the only three studies that looked at patients 40 years or older ranged from 40 to 48.7%, which is a markedly lower range than the above-mentioned rates achieved amongst women of reproductive age. These authors [19,24,26,27,28] also demonstrated that raised body mass index and prolonged duration of sterilization decreased pregnancy rates significantly. The question is raised whether prolonged duration of sterilization to reversal is not rather related to older age as a causative factor for infertility.…”

Section: Discussionmentioning

confidence: 99%

“…Amongst these factors, literature points to age as the most significant factor [3,19,24,25,26]. As would be expected, pregnancy rates in the only three studies that looked at patients 40 years or older ranged from 40 to 48.7%, which is a markedly lower range than the above-mentioned rates achieved amongst women of reproductive age.…”

Section: Discussionmentioning

confidence: 99%

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Objective: To compare efficacy of sterilization reversals by laparotomy versus laparoscopy. Design: Meta-analysis. Search Strategy: Electronic searches were carried out for randomized controlled trials and retrospective and prospective clinical studies. Search engines such as PubMed, Science Direct, Medline and the Cochrane database were made use of. Our restrictions were English human studies published from 1989 to January 2010. Interventions: Microsurgical tubal reanastomosis performed comparing laparoscopy with laparotomy using a microsurgical technique. Outcome Measures:Primary: overall pregnancy rates, including positive clinical pregnancy, intrauterine and ectopic pregnancy rates. Secondary: surgery time. Results: Three retrospective comparative studies were retrieved from international data that investigated laparotomy versus laparoscopy. A total number of 184 patients were included, 88 and 96 respectively undergoing laparoscopy and laparotomy. Pregnancy rates achieved by laparoscopy ranged from 65 to 80.5% (mean 74.43%) and by laparotomy from 70 to 80% (mean 71.33%). A subanalysis of two of the three comparative studies show that laparoscopy reversal surgery requires a statistically significant longer operative time than does laparotomy (p < 0.00001). Conclusions: There is no difference between the laparoscopy and laparotomy approach to tubal reanastomosis when regarding overall pregnancy rates, intrauterine and ectopic pregnancy rates.

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