난관 문합술에 있어서 일측문합 및 양측문합에 따른 임신성공율의 비교

Abstract

Between May, 1984 and November, 1989, 64 cases of tubal reversals which were performed by micosurgical techniques, in arbitary chosen, at the Department of Obstetrics & Gynecology, Keimyung University Hospital were reviewed for comparison & evaluation of pregnancy rates & its influencing factors between unilateral & bilateral tubal reversals. Among them. each 32 cases were performed by unilateral reversals & bilateral reersals, respectively. The mean age was 30.2 yrs in the unilateral subgroup & 31.7 yrs in the bilateral subgroup. Average interval between sterilization & reversals was 48.7 months in the unilateral subgroup & 53.6 months in the bilateral subgroup. The majority of two groups had been sterilized by laparoscopic procedures(43.8% in the unilateral subgroup & 90.7% in the bilateral subgroup). In two groups, the most common sites of the anastomosis were isthmic-ampu-lary portion in the unilateral group(37.5%) & isthmic-isthmic portion in the bilateral group(48.4%). The most common cause undergoing unilateral tubal reversals was tubal obstruction(43.8%). The postoperative length of the tube was 5cm or more in 96.9% in each subgroup. Of all 64 cases, 12 cases out of 25 unilateral cases (48%) which werefollowed up among 32 unilateral cases and 20 cases out of 25 bilateral cases (80%) which were followed up among 32 bilateral cases, had achieved pregnancies, so then statistical difference was found in pregnancy rates between two groups. (p<0.01) In pregnant women, three was no statistical significance in the postoperative tubal length & interval between surgery & conception favoring bilateral subgroup(p>0.05), and mean age & duration of sterilization and no statistical difference between two groups(p>0.05). Between two surgical groups, no statistical difference was found in the pregnancy rates according to the method of previous sterilization, the sites of tubal anastomosis, the postoperative tubal length, and the duration of sterilization(p>0.05). The rates of spontaneous abortion were 17% (2 cases/12 cases) in the unilateral subgroups and 10% (2 cases/20 cases) in the bilateral subgroups, and the rate of ectopic pregnancy was 17% (2 cases/12 cases) in the unilateral subgroup & 10% (2 cases/20 cases) in the bilateral subgroup, again showing no statistical difference in the rates of spontaneous abortion & ectopic pregnancy(p>0.05).