{Reference Type}: Journal Article
{Title}: Tubal anastomosis after tubal sterilization: a review.
{Author}: Deffieux X;Morin Surroca M;Faivre E;Pages F;Fernandez H;Gervaise A;
{Journal}: Arch Gynecol Obstet
{Volume}: 283
{Issue}: 5
{Year}: May 2011
{Factor}: 2.493
{DOI}: 10.1007/s00404-011-1858-1
{Abstract}: <B>OBJECTIVE: </B>To evaluate various techniques for restoring tubal patency after sterilisation.<BR><B>METHODS: </B>A search strategy was designed, and for each subject either thesaurus terms (MeSH descriptors) or terms from the title or summary were used.<BR><B>RESULTS: </B>Mean length of hospital stay following laparoscopy seems to be shorter in comparison with laparotomy (3.3 vs. 6.1 days, P < 0.05). Rate of conversion to laparotomy is 5%. Pregnancy rates observed are between 54 and 88% for laparotomy and 31-85% for laparoscopy. Mean time to conception was between 2 and 9.6 months. Most pregnancies occurred in the 2 years following restoration of tubal patency (cumulative conception rate 80% at 12 months). Young age (<35 years), type of ligature (rings), how recently the ligature was done (<8 years), the anastomosis site (in the middle of the tube) and a good length of remaining tube (>7 cm) are the factors that govern whether there can be good restoration of tubal patency. Ectopic pregnancy rates observed are between 1.7 and 12% for laparotomy and 0-7% for laparoscopy. There are no randomised or quasi-randomised studies comparing tubal anastomosis and in vitro fertilization.<BR><B>CONCLUSIONS: </B>There are few good-quality controlled studies in this area. Results of restoration of tubal patency seem to be comparable, regardless of the route of approach (laparotomy or laparoscopy).