A procedure for restoration of fallopian tube patency in tubal pregnancy in the ampullary portion

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Clinical case of successful pregnancy in a patient with ectopic ACTH syndrome after radical surgical treatment. Russian Journal of Human Reproduction. 2024;(6):118-123

Objective — to describe of a new method for organ-sparing surgical treatment in patients with tubal pregnancy to enhance the efficiency of surgery and fertility restoration. Material and methods. The procedure for restoration of fallopian tube patency in tubal pregnancy in the ampullary portion is that the part of the latter of the fallopian tube undergoes laparoscopic resection (neostomatoplasty) in these patients. Bipolar coagulation of the mesosalpinx and fallopian tube to the border of intact tissues is followed by resection of the ampullary portion of the fallopian tube with an ovum, salpingoneostomatoplasty of the stump of the fallopian tube. Surgical treatment was performed by the proposed fashion in 58 patients with progressive and interrupted tubal pregnancy in the ampullary portion (a study group). A comparison group consisted of 128 patients with tubal pregnancy, who underwent organ-sparing surgery as laparoscopy, salpingostomy, oval removal. Results. A retrospective analysis of the medical records of these patients was performed and the long-term results of fertility restoration (the occurrence of intrauterine pregnancy) were analyzed. The fallopian tubes were patent in 34 (58.6%) patients, which is 1.7 times more than those undergoing traditional organ-sparing surgery (128 patients in the comparison group; p<0.05). The intrauterine pregnancy rate in the study group was 2 times higher than in the comparison group (p<0.05). Conclusion. The new optimized procedure has no such contraindications as to the known organ-sparing techniques and it requires no repeated fallopian tubal reconstructive surgery and increases fallopian tube patency restoration rates and fertility in patients with tubal pregnancy.

Keywords:

tubal pregnancy

salpingotomy (salpingostomy)

salpingectomy

ampullary portion of the fallopian tube

resection of a part of the ampullar portion of the fallopian tube

restoration of fallopian tube patency

fertility

Authors:

Fetishcheva L.E.

M.A. Podgorbunsky Regional Clinical Hospital of Emergency Medical Care, Kemerovo, Russia

Novikova O.N.

Obstetrics and Gynecology Department One, Kemerovo State Medical Academy, Ministry of Health of Russia, Kemerovo, Russia

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