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Objective To evaluate efficacy and safety of laparoscopic surgery for ectopic pregnancy with hemorrhagic shock.Methods One hundred and thirty women with hemorrhagic shock due to ectopic pregnancy underwent laparoscopic surgery from January 2003 to August 2006,including salpingectomy in 80 cases,partial ovariotomy in 8 cases,uterus wedge resection in 15 cases,salpingotomy in 19 cases,and tubal lesion clearance in 8 cases.Results Laparoscopic surgery was successfully performed in all the cases.Intra-abdominal blood loss was 1000 to 3500 ml,with an average of 1500 ml.The operation time was 30-60 minutes(mean:40 minutes).No postoperative complication occurred.Follow-up was conducted in 106 cases,once in a week in the first month after discharge.Serial ?-hCG levels decreased gradually and reached the normal level 1-2 weeks after operation.Persistent ectopic pregnancy was not found in the studied cases.Conclusions Laparoscopic surgery is a safe and effective treatment for hemorrhagic shock due to ectopic pregnancy,given the skill of an experienced laparoscopist with the aid of optimal anesthesia and advanced cardiovascular monitoring.
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Objective To investigate the diagnostic value and therapeutic effect of laparoscopy combined with hysteroscopy in patients with tubal infertility.Methods A total of 133 patients with tubal infertility were treated by laparoscopy combined with hysteroscopy in our hospital from September 2004 to December 2007.All the cases were diagnosed by hysterosalpingography(HSG) and hysteroscopy.Results Totally 225 fallopian tubes were examined in the 133 patients,among which 180 tubes were completely occluded,57 were partially occluded,and 18 were patent.After the surgeries,211 tubes wee patent,24 were partially blocked,while 20 were still occluded.The success rate of the operations was 81.4%(193/237).Follow-up was achieved in 92 patients for 4 to 18 months,in the cases,30 were pregnant during the period(pregnancy rate: 32.6%).Of the 30 cases,2 women had tubal pregnancy;22 women were pregnant in 6 months after the treatments,and the other 8 were pregnant in 6-12 months after the operations.In this group of patients,the pregnancy rate in the women with both patent fallopian tubes was 26.1%(24/92),and in those with single patent fallopian tube was 6.5%(6/92).The pregnancy rate in patients with simple tubal infertility was 22.8%(21/92),while that of those who were complicated with tubal diseases was 9.8%(9/92).Conclusion Laparoscopy combined with hysteroscopy can accurately diagnose tubal infertility,and improve the therapeutic effect.
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Objective To investigate the feasibility and safety of laparoscopic surgery of giant hysteromyoma.Methods A total of 56 cases of giant hysteromyoma(at least 1 lesion ≥ 9 cm in diameter) underwent laparoscopic operations from January 2003 to August 2006 in this hospital.There were 30 cases of laparoscopic myomectomy(LM),10 cases of laparoscopic-assisted vaginal hysterectomy(LAVH),1 case of total laparoscopic hysterectomy(TLH),and 15 cases of laparoscopic supracervical hysterectomy(LSH).Results All of the operations were successfully performed under laparoscope.No conversion to open surgery was needed.The operation time was 40～100 min(mean,52 min),and the hemorrhage volume was 10～100 ml(mean,45 ml).Postoperatively,ureterovaginal fistula was observed in 1 case,which was cured by a re-operation of laparoscopic ureteroneocystostomy.Conclusions Laparoscopic operation for giant hysteromyoma is safe and feasible.