Microcirugía ginecologica en infertilidad. 7 Anos de experiencia

In: Revista Colombiana de Obstetricia y Ginecología · 1989 · vol. 40(2) , pp. 137–144 · doi:10.18597/rcog.2432 · W2510344838
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This study reports pregnancy rates for 175 infertile patients undergoing various microsurgical procedures for tuboperitoneal factors, with results ranging from 14% to 74% depending on the specific procedure and pathology severity.

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The paper reports a 7-year experience with microgynecologic surgery in 175 infertile patients attributed to tuboperitoneal factor, classified based on laparoscopic and hysterosalpingographic findings and treated by the same surgeon using a surgical microscope. After follow-up of 12–60 months, pregnancy rates varied by procedure: highest for salpingolysis (74%), ovariolysis (71%), tube-to-tube anastomosis (70%), and lower for tubouterine implantation (50%), fimbrioplasty (50%), pelvic adhesiolysis (43%), salpingostomy (29%), and combined adhesiolysis with salpingostomy (14%). The results correlated inversely with the severity of underlying pathology, and the authors state micro-surgery as an excellent treatment for tuboperitoneal factor infertility, while the reported design offers no explicit comparator or randomized evaluation. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Presentamos nuestra experiencia en 175 pacientes infértiles por factor tuboperitoneal tratadas con microcirugía. Fueron clasificadas acorde a los hallazgos de la laparoscopia y la histerosalpingografía e intervenidas por un mismo cirujano utilizando microscopio quirúrgico. Después de un seguímiento de 12 a 60 meses se han obtenido las siguientes tasas de embarazos: salpingolisis 74%; ovariolisis 71%; anastomosis tubo-tubáricas 70%; implantes tubo-uterinos 50%; fimbrioplastias 50%; adhesiolisis pélvica 43%; salpingostomías 29% y combinaciones de adhesiolisis pélvica y salpingostomías 14%. Los resultados se correlacionan inversamente con la severidad de la patología subyacente. La microcirugía es un excelente tratamiento del factor tubo-peritoneal.
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Microcirugía ginecológica en infertilidad. 7 Años de experiencia DOI: https://doi.org/10.18597/rcog.2432Resumen Presentamos nuestra experiencia en 175 pacientes infértiles por factor tuboperitoneal tratadas con microcirugía. Fueron clasificadas acorde a los hallazgos de la laparoscopia y la histerosalpingografía e intervenidas por un mismo cirujano utilizando microscopio quirúrgico. Después de un seguímiento de 12 a 60 meses se han obtenido las siguientes tasas de embarazos: salpingolisis 74%; ovariolisis 71%; anastomosis tubo-tubáricas 70%; implantes tubo-uterinos 50%; fimbrioplastias 50%; adhesiolisis pélvica 43%; salpingostomías 29% y combinaciones de adhesiolisis pélvica y salpingostomías 14%. Los resultados se correlacionan inversamente con la severidad de la patología subyacente. La microcirugía es un excelente tratamiento del factor tubo-peritoneal. Biografía del autor/a Luis Ernesto Pérez Agudelo, Universidad Nueva Granada Profesor Asociado y Jefe de la Unidad de Infertilidad y Endocrinología Reproductiva. Referencias bibliográficas ALLYN, D.P.; LETON, D.A.; WESTCOTT, N.A.; HALE, R.W. Presterilization counseling and women’s regret about having been sterilized. J. Reprod. Med. 31 (11): 1027-32, 1986. ABRAHAM, S.; JANSEN, R.; FRASER, I.S.; KWOK, C.H. The characteristics, perceptions and personalities of women seeking a reversal of their tubal sterilization. Med. J. Aust. 145 (1): 4-7, 1986. ALFONSIN, A.E. Tratamiento quirúrgico del factor tubárico: técnicas y resultados. En: Avances en Reproducción Humana, editado por Asch R.H., Acosta A. Editorial Panamericana, Buenos Aires 1988. BREMOND, A.; NACHURY, L.P.; NICOLLET, B.; QUE-NARD, N.; MARTIN, A.: Sterilitiy of tubal origin: microsurgery and fertilization in vitro. Rev. Fr. Gynecol. Obstet. 81 (4): 237-42, 1986. BUTTRAM, V.C.; REITER, R.C. En: Surgical treatment of the infertile female. Editorial Williams & Wilkins, Baltimore/London, 1985. COHEN, B.M. Surgical Repair of Abnormal Fimbrial Gonadal Relationships in Human Female. J. of Reprod med. 25: 33. DODGE, S.T.; PUMPHREY, R.S.; MIYAZAWA, K. Peritoneal endometriosis in women requesting reversal of sterilization. Fértil Steril 45 (6): 774-7, 1986. EDDY, C.A.; ANTONINI, R. JR., PAUERSTEIN, C.J.: Fertility following microsurgical removal of the ampullary-isthmic junction in rabbits. Fértil Steril 28: 1090, 1977. FAYEZ, J.A. Comparison between tubouterine implantation and tubouterine anastomosis for repair of cornual occlusion. Microsurgery 8 (2): 78-82, 1987. GOMEL, V. Microsurgical Reversal of Female Sterilization: A Reappraisal. Fértil Steril 33: 587, 1980. GOMEL, V.; SWOLIN, K. Salpingostomía: Técnica microquirúrgica y resultados. Clínicas Obstétricas y Ginecológicas 4: 1305, 1980. GOMEL, V. An odyssey throught the oviduct. Fértil Steril 39: 144, 1983. GOMEL, V. En: Microsurgery in female infertility. Editado por: Little, Brown and Company, Boston, Toronto, 1983. GALEN, D.I.; JACOBSON, A. A successful microsurgical reanastomosis program in a community hospital. J. Reprod. Med. 31 (7): 595-6, 1986. GUPTA, A.N.; CHAKRAVARTI, R.N.; MAJUMDAR, S.; MAPA, M.K.; DHALL, G.I.: Pathological changes in fallopian tubes following three different kinds of occlusive techniques in primates. Contraception 33 (3): 245-55, 1986. JANSEN, R.P. Tubal resection and anastomosis I. Sterilization-reversal. Aust NZ J. Obstet. Gynaecol 26 (4): 294-9, 1986. KITCHIN, J.D. 3d., NUNLEY, W.C. Jr., BATEMAN, B.G. Surgical management of distal tubal occlusion. Am. J. Obstet. Gynecol 155 (3): 524-31, 1986. LAND, J.A. Tubal microsurgery. I. The principales. Gynecol Obstet. Invest. 23 (2): 73-8, 1987. LIMPAPHAYOM, K. Tubo tubal anastomosis for reversal of female sterilization in Thailand. J. Reprod. Med. 31 (7): 601- 4, 1986. LAVY, G.; DIAMOND, M.P.; DECHERNEY, A.H. Pregnancy following tubocornual anastomosis. Fértil Steril 46 (1): 21- 5, 1986. LUBER, K.; BEESON, C.C.; KENNEDY, J.F.; VILLANUEVA, B.; YOUNG, P.E. Results of microsurgical treatment of tubal infertility and early second-look laparoscopy in the post-pelvic inflamatory disease patient: implications for in vitro fertilization. Am. J. Obstet. Gynecol. 154 (6): 1264-70, 1986. MCLAUGHLIN, D.S.; BONAVENTURA, L.M.; JARRETT, J.C. 2d: Tubal reanastomosis: a comparison between micro-surgical and microlaser techniques. Microsurgery 8 (2): 83-8, 1987. MCCOMB, P.; BOER-MEISEL, M.; GOMEL, V. The influence of fallopian tube ampullary lenght on the fertility of the rabbit. Int. J. Fértil 26: 30, 1981. MCCOMB, P.; GOMEL, V. Oclusión cornual y su reconstrucción microquirúrgica. Clin. Obstet. Gynecol. 4: 1291, 1980. NOVY, M.J. Reversal of Kroner fimbriectomy sterilization. J. Obstet. Gynecol 137: 198, 1980. PATTON, P.E. WILLIAMS, T.J.; COULAM, C.B. Results of microsurgical reconstruction in patients with combined proximal and distal tubal occlusion: double obstruction. Fértil Steril 48 (4): 670-4, 1987. PATTON, P.E.; WILLIAMS, T.J.; COULAM, C.B. Microsurgical reconstruction of the proximal oviduct. Fértil Steril 47 (1): 35-9, 1987. PEREZ, L.E.; EDDY, C.A. Ovum transport and fertility following microsurgical removal of the isthmus and uterotubal junction (UTJ) in rabbits. Biol. Reprod. 22: 72 (A), 1980. PEREZ, L.E.; RAJKUMAR, K.; EDDY, C.A. Fertility and Ovum transport after microsurgical removal of the uterotubal junction in rabbits. Fértil. Steril 36: 803, 1981. PEREZ, L.E.; FLORES, J.J.; BAJPAI, V.K. ASCH, R.H. and EDDY, C.A: Fertility following finbriectomy and tuboova-rian microsurgery in rabbit. Fértil Steril 35: 573, 1981. PEREZ, L.E. Tratamiento del Factor tubo-peritoneal con microcirugia. Rev. Col. Obstet. Ginecol 35 (3): 185, 1984. PEREZ, L.E.; ABDALA, L.T. Microcirugía Ginecológica en Infertilidad, Siete años de experiencia. Memorias II Congreso Latinoamericano de Fertilidad y Esterilidad (pág. 194), Bogotá, Colombia Oct. 1987. PEREZ, L.E.; MENDOZA, J.C. Cirugía conservativa y Danazol como tratamiento de la infertilidad por endometriosis severa y extensiva. Presentado en el XVII Congreso Colombiano de Obstetricia y Ginecología, Pereira, Diciembre de 1987. ROCK, J.A.; GUZICK, D.S.; KATZ, E.; ZACUR, H.A.; KING, T.M. Tubal anastomosis: pregnancy success following reversal of Falope ring or monopolar cautery sterilization. Fértil Stetil 48 (1): 13-7,1987. Reversing female stelization: Population Reports. Series CN-8, 1980. RUEDA GONZALEZ, R,; RUEDA SAENZ, R. Guías Diagnósticas en infertilidad. Editado por ACEP, Bogotá, 1987. SILVA, P.D.j SILVA, D.G.; DE LA MAZA, L.M.; PETERSON, E.M.; STONE, S.C. Oviductal cilial phagocytosis in patients undergoing tubal reanastomosis. Fértil Steril 47 (2): 353-5, 1987. SUCHET, J.H.; LOFFREDO, V. Tratamiento quirúrgico de las esterilidades tubáricas. Interés del injerto de peritoneo libre y de la laparoscopia precoz en la proyección de las adherencias. Presse Medícale 2: 341, 1980. SCHEIDEL, P.H., et al: Absorbable or nonabsorbable suture material for microsurgical tubal anastomosis Randomized experimental study on rabbits. Gynecol, Obstet. Invest. 21 (2): 96-102, 1986. SPIVAK, M.M.; LIBRACH, C.L.; ROSENTHAL, D.M. Micro-surgical reversal of sterilization: a six-year study. Am. J. Obstet. Gynecol 154 (2): 355-61, 1986. THIE, J.L.; WILLIAMS, T.J.; COULAM, C.B. Repeat tuboplasty compared with primary microsurgery for postinflamatory tubal disease. Fértil Steril 45 (6): 784-7, 1986. TAYLOR, P.J., et al: Female sterilization: can the woman who will seek reversal be identified prospectively? Clin. Re-prod Fértil 4 (3): 207-15, 1986. WISTON, R.M.L. Microsurgical tubocornual anastomosis for reversal of sterilization. Lancet 1: 284-285, 1977. WISTON, R.M.L. Microsurgical tuboplasty. Hammersmith Hospital. London. Copyright Downs surgical, 1978. WISTON, R.M.L. Reversion de la estilización tubárica. Clin. Obstet. y Ginecol 4: 1328, 1980. Cómo citar Descargas Descargas Publicado Número Sección | Estadísticas de artículo | | |---|---| | Vistas de resúmenes | | | Vistas de PDF | | | Descargas de PDF | | | Vistas de HTML | | | Otras vistas |

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