[Microsurgery of distal tubal lesions. Analysis of 270 operated cases]

Between 1978 and 1983, more than 600 microsurgical tubal operations were performed. Only 270 women with the same extent of distal tubal lesions on both sides or with unilateral tubal occlusion after heterolateral salpingectomy were considered in this study. The authors propose a classification of distal tubal lesions in order to analyze the results of microsurgery. After fimbrioplasty, salpingolysis and salpingostomy for distal occlusion without ampullary dilatation, the term pregnancies rate is more than 50%. The pregnancy rate after salpingostomy for hydrosalpinx is 25%. The prognosis after microsurgery for distal tubal lesions is related to ciliated cells percentage. The prognosis of microsurgical salpingostomy for thick-walled hydrosalpinx is poor. In these cases, in vitro fertilization should be the treatment of preference. In conclusion, the ampullary diameter and the fimbrial ciliated cells percentage are prognostic factors of distal tubal microsurgery.