Effect of laparoscopic salpingectomy and laparoscopic salpingostomy on ovarian reserve function and clinical prognosis in patients with tubal pregnancy salpingostomy
Objective:To investigate the effect of laparoscopic salpingostomy and salpingectomy on ovarian reserve function and clinical prognosis in patients with tubal pregnancy.Methods:A total of 86 patients with tubal pregnancy who underwent laparoscopic surgery in Yongkang Maternal & Child Health Care Hospital from January 2020 to December 2022 were included in this study.According to the random number table,they were divided into the salpingectomy group(n=43)and the salpingostomy group(n=43).The perioperative indexes,serum hormone level,ovarian reserve function and clinical prognosis were compared between the two groups.Results:There were no significant differences in the operation time,anal exhaust time,the amount of intraoperative blood loss,the duration of hospital stay and postoperative complications between two groups(P＞0.05).At the sixth month after operation,the serum levels of FSH and LH in the salpingostomy group were significantly lower than those in the salpingectomy group[(3.71±0.56)U/L vs.(5.72±0.73)U/L,(5.62±0.56)U/L vs.(7.14±0.67)U/L,respectively,P＜0.05],but the serum levels of estradiol(E2)and anti-Müllerian hormone(AMH)in salpingostomy group were significantly higher than those in salpingectomy group[(255.03±28.08)pmol/L vs.(212.27±21.32)pmol/L,(3.54±0.36)ng/ml vs.(2.45±0.31)ng/ml,respectively,P＜0.05].At the sixth month after operation,the ovarian diameter(MOD),antral follicle count(AFC),ovarian average volume(OAV),peak systolic velocity(PSV)and end diastolic velocity(EDV)of ovarian stromal arteries in the salpingostomy group were significantly higher than those of the salpingectomy group(P＜0.05),but the level of resistance index(RI)in salpingostomy group was significantly lower than that in salpingectomy group(P＜0.05).The intrauterine pregnancy rate in one-year follow-up in the salpingostomy group was significantly higher than that in the salpingectomy group(83.72％vs 48.84％,P＜0.05),while the ectopic pregnancy rate and secondary infertility rate were significantly lower than those in salpingectomy group(P＜0.05).Conclusions:Laparoscopic salpingostomy has more advantages in improving ovarian reserve function and clinical prognosis when compared with laparoscopic salpingectomy.
万方数据
维普
