日本産科婦人科内視鏡学会雑誌
Online ISSN : 1884-5746
Print ISSN : 1884-9938
手術手技
腹腔鏡下卵管妊娠手術の臨床的検討
-腹腔鏡下卵管温存手術におけるvasopressinとmethotrexateの卵管内局所投与の有用性-
岡田 由貴子高橋 良樹中妻 杏子鈴木 幸之助林 香里山ノ井 康二鈴木 彩子
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2014 年 30 巻 1 号 p. 286-291

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  We examined the clinical usefulness of intratubal vasopressin and methotrexate administration during conservative laparoscopic surgery for tubal pregnancy. A total of 49 patients who underwent conservative laparoscopic surgery for tubal pregnancy from January 2003 through December 2012 were enrolled in the study. All patients who had vasopressin and methotrexate (10 mg) injected into the tubal pregnancy during conservative laparoscopic surgery were treated by either a linear salpingostomy or fimbrial milking evacuation (removal of embryonic tissue alone). In 48 (98%) of 49 patients, the fallopian tubes were preserved by the conservative laparoscopic surgery, which included the intratubal injection of vasopressin and methotrexate. The incidence of persistent ectopic pregnancy was 0 (0%) of 50, and a recurrent ipsilateral tubal pregnancy was observed in 7% of 15 patients who achieved another pregnancy. The intratubal injection of vasopressin and methotrexate during conservative laparoscopic surgery for tubal pregnancy is a safe and more effective regimen for preservation of the fallopian tube as well as prevention of a persistent ectopic pregnancy.
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