title: Tubal anastomosis after tubal sterilization: a review.
abstract: OBJECTIVE
  To evaluate various techniques for restoring tubal patency after sterilisation.
  
  
  METHODS
  A search strategy was designed, and for each subject either thesaurus terms (MeSH descriptors) or terms from the title or summary were used.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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).
authors.affiliation: Faculté de Médecine, Université Paris-Sud, Le Kremlin Bicêtre, F-94274 Paris, France. xavier.deffieux@abc.aphp.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Deffieux
authors.forename: Michèle
authors.initials: M
authors.lastname: Morin Surroca
authors.forename: Erika
authors.initials: E
authors.lastname: Faivre
authors.forename: Frédérique
authors.initials: F
authors.lastname: Pages
authors.forename: Hervé
authors.initials: H
authors.lastname: Fernandez
authors.forename: Amélie
authors.initials: A
authors.lastname: Gervaise
mesh_terms: D000714:Anastomosis, Surgical; D005187:Fallopian Tubes / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D013243:Sterilization Reversal / Q000379:methods*; D013246:Sterilization, Tubal