EFFICIENCY OF PARTIAL RESECTION OF AMPULLA OF UTERINE TUBE WITH THE FOLLOWING SALPINGOSTOMY IN PATIENTS WITH ECTOPIC PREGNANCY TO PRESERVE THEIR FERTILITY

Aim. To evaluate the efficacy of partial resection of ampulla of uterine tube followed by salpingostomy compared to salpingostomy alone in patients with tubal pregnancy. Materials and Methods. We recruited 182 females with tubal pregnancy who were then randomized to undergo either endoscopic partial resection of ampulla of uterine tube followed by salpingostomy (n = 58) or endoscopic salpingostomy alone (n = 124). After 3 months, all patients underwent a second-look laparoscopy combined with hydrotubation to evaluate the outcome and Fallopian tube patency. Semi-quantitative assessment of pelvic adhesions was carried out by calculation of peritoneal adhesion index, by revised American Fertility Society classification system (r-AFS), and by modified classification of pelvic adhesions after caesarean section. In 12 months, the final outcome was evaluated by means of restored fertility and according to hysterosalpingography. Results. In 3 months postoperation, patients who underwent partial resection of ampulla of uterine tube followed by salpingostomy were characterized by higher Fallopian tube patency, lower prevalence and severity of pelvic adhesions, and lower prevalence of persistent trophoblastic disease. Single salpingostomy also showed certain advantages such as lower time of surgery and better opportunities for repeated reconstructive operations. In 12 months, restored fertility was more prevalent in patients who underwent partial resection of ampulla of uterine tube followed by salpingostomy that was in keeping with higher Fallopian tube patency. Conclusion. Partial resection of ampulla of uterine tube followed by salpingostomy is an efficient alternative to salpingostomy alone and can be used in women with tubal pregnancy to increase their chances to restore fertility.

внематочная беременность, сальпингостомия, резекция маточной трубы, неостоматопластика, tubal pregnancy, salpingostomy, Fallopian tube resection

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