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PubMed1982

Microsurgery of the fallopian tube with the carbon dioxide laser: eighty-two cases with follow-up.

In 1974 the carbon dioxide laser was adapted to the operating microscope for reconstructive pelvic surgery and the first 15 cases of laser tubal microsurgery were performed. The instrumentation and techniques were refined. A protocol was designed to test the efficacy of this surgical modality, and a new study was begun in 1980. Complete documentation of laparoscopic findings, surgical techniques, and pre- and postoperative hysterosalpingograms are kept on videotapes. Detailed descriptions of the surgical techniques employed in these cases are presented in this paper. Preliminary results are reported in terms of patency and pregnancy rates experienced to date. Eighty-two women experienced fertility enhancement laser microsurgery at the Reproductive Biology Center at F. Edward Hebert Memorial Hospital in New Orleans. Bilateral patency or patency of the only existing fallopian tube was demonstrated postoperatively in 93% of the cases. Eliminating the women practicing contraception, those on postoperative Danazol therapy for endometriosis, male factors, or other reasons for women or their partners being not at risk, conception has occurred 21 times among 20 of 42 patients at risk. Many of the women were referral cases who had had unsuccessful microsurgery or were rejected for microsurgery by their physicians due to extensive disease. These results indicate that the carbon dioxide surgical laser may be a useful adjunct in reconstructive microsurgery for fertility dysfunction.

Adult↗
PubMedDate not supplied

Reconstructive microsurgery of the fallopian tube with the carbon dioxide laser - procedures and preliminary results.

UNLABELLED: In 1974 the carbon dioxide laser was adapted to the operating microscope for reconstructive pelvic surgery. A protocol was designed to test the efficacy of this surgical modality and a new study begun. Complete documentation of laparoscopic findings, surgical technique, and pre- and post-operative hysterosalpingograms are kept on videotape. One hundred cases will be entered into this study. Patency and pregnancy failures will be compared with patency and pregnancy successes to determine, if possible, the reasons for failure. In this paper detailed descriptions of the surgical techniques employed in the first 61 cases are presented. PRELIMINARY RESULTS in terms of patency and pregnancy experience to date are reported. PRELIMINARY RESULTS: Eighty-two couples have been evaluated at the Reproductive Biology Unit. Sixty-one cases have undergone fertility enhancement laser microsurgery and/or interim medical management prior to surgery for infertility. Bilateral patency or patency of the only existing fallopian tube was demonstrated post-treatment in 93% or 57 of the cases. Eliminating those cases who are not at risk of pregnancy due to elective contraception or medical prohibition during Danocrine therapy (28), conception has occurred in 10 of 33 patients. This represents approximately one of every three patients at risk. Considering the limited exposure to pregnancy, these results are very encouraging.

Adult↗
PubMed2000

Establishment of a ciliated epithelial cell line from human Fallopian tube.

Human tubal epithelial cells in primary culture were transfected with simian virus 40 (SV40) large T antigen plasmid, and an immortalized ciliated cell line, named as NT/T-S, was established without crisis. Transmission electron microscopy proved that NT/T-S cells had cilia, microvilli, junctional complexes, rough endoplasmic reticula, free ribosomes and microtubules. NT/T-S cells were evaluated preliminarily on the basis of co-culture study using surplus embryos at the 4- to 8-cell stage in our IVF and embryo transfer programme. All of the 133 embryos had >/=10% fragments (based on the surface area) and were unworthy of cryopreservation. Up to 57% (16/28) of the embryos with 10-30% fragments reached the blastocyst stage by co-culture. In contrast, blastocyst formation was observed in <10% of the control embryos, some of which were co-cultured with NFL/T cells (the immortalized human fetal liver epithelial cells) (1/16), and the others were incubated with the co-culture medium alone (1/18). Various cytokines/growth factors such as leukaemia inhibitory factor (LIF), interleukin (IL)-6, IL-8 and basic fibroblast growth factor were secreted by NT/T-S cells as well as by the tubal epithelial cells in primary culture. The establishment of a ciliated cell line will provide a valuable resource for the further studies of the Fallopian tube in the early events of pregnancy.

Blastocyst↗
PubMed2003

Evidence of chlamydial infection in infertile women with fallopian tube obstruction.

The study was carried out to find the prevalence of Chlamydia trachomatis seropositivity among women with infertility of tubal origin. Forty women with tubal infertility (verified at hysterosalpingography and laproscopy), 20 women with infertility due to variety of other reasons and 20 healthy fertile women of reproductive age were enrolled in the study. It was found that the presence of Chlamydia specific IgG antibody was significantly higher (70%) in women with infertility of tubal origin as compared to 35% seropositivity in healthy fertile women and 55% seropositivity in infertile women with cause of infertility other than tubal factor. Seventy eight percent of women with frequency of coitus 3-4 times/week were seropositive as compared to 34.7% when frequency of coitus was 1-2 times/week. Study also showed the silent nature of this infection as history suggestive of past pelvic inflammatory disease (PID) was lacking in majority of the seropositive women (63.75%). In the study group, both the ends of the fallopian tubes (cornual and distal block) were involved with almost equal frequency. Eighty three percent of women with seropositivity had unilateral or bilateral hydrosalpinx and 75% of women had marked pelvic adhesions. These results support the fact that there is strong association between serum anti-Chlamydial antibodies and tubal factor as a cause of infertility in infertile women.

Adult↗
PubMed1997

Tumors of the fimbriated end of the fallopian tube: a clinicopathologic analysis of 20 cases, including nine carcinomas.

Twenty tumors that were primary in the tubal fimbriae are reported. They were found in patients aged 17 to 83 (average 57) years. All were of mullerian type. Nine tumors were benign (eight adenofibromas, one cystadenoma), of which seven were serous and two, endometrioid. Two tumors were borderline, a serous papillary cystic tumor of borderline malignancy and an endometrioid adenofibroma of borderline malignancy. Nine tumors were carcinomas, of which four were serous, three endometrioid, and two undifferentiated. Follow-up information was available for six patients with carcinoma. One with serous carcinoma was well at 1 year; a second had ascites with malignant cytologic features nine years postoperatively and is currently on chemotherapy. One patient with endometrioid carcinoma was alive without disease after 8 years, and the other died of tumor at 6.5 years. One patient with undifferentiated carcinoma was alive without disease at 5 years and the other died of disease at eight months. The occurrence of fallopian tube tumors that arise in the fimbriae has received scanty attention in the literature. A fimbrial origin for the tumors is often overlooked initially. Carcinomas confined to the fimbriae cannot be adequately staged according to the current staging system of the International Federation of Gynecology and Obstetrics. It is proposed that they be placed in a new category, Stage I(F), because the tumor cells are exposed directly to the peritoneal cavity even though they do not invade the tubal wall. Although experience is limited it appears that they may have a worse prognosis than Stage I tubal tumors that are nonfimbrial.

Adenofibroma↗
PubMed1984

[Microsurgery of the fallopian tube].

9 per cent of all patients with female sterility are indicated to be operated on. After discussing the conditions for microsurgery the indications like salpingolysis, ovariolysis, fimbrioplasty, salpingoneostomia, anastomosis, conservative operations of ectopic pregnancy and endometriosis are argued in detail. Microsurgery improves pregnancy rates about 20 per cent. The principles of microsurgery should have a wider entrance in gynecologic operations.

Endometriosis↗
PubMed1991

Cisplatin-based combination chemotherapy in carcinoma of the fallopian tube.

Forty-three cases of primary tubal adenocarcinoma were treated at Memorial Sloan-Kettering Cancer Center between 1979 and 1989. Thirty-eight patients who received cisplatin-based combination chemotherapy following primary surgery were reviewed. The mean patient age was 59 years, with 86% postmenopausal. Distribution by stage was as follows: I, 3 (7%); II, 4 (11%); III, 27 (71%); and IV, 4 (11%). Median follow-up from the time of diagnosis was 62 months (range, 5-132). Overall survival for all 38 patients by Kaplan-Meier analysis was 51% at 5 years. Excluding stage I, patients with no residual disease following surgery had a significantly higher 5-year survival (83%) than those left with gross residual disease (28%). Twenty-six patients underwent a second-look procedure. Of the 21 patients with advanced (stages III, IV) disease undergoing reexploration, 11 (52%) had a negative second-look and 10 (48%) were positive. Ten of the eleven patients with a negative second-look remain clinically free of disease with a median follow-up of 49 months. One patient with stage III disease had recurred after 47 months. Carcinoma of the fallopian tube appears to respond favorably to cisplatin-based multiagent chemotherapy. Patients with advanced-stage disease who achieve a negative second-look appear to have an improved possibility of remaining disease-free over similar-stage patients with ovarian cancer.

Adult↗