title: Laparoscopic Fimbrioplasty and Neosalpingostomy in Female Infertility: A Review of 402 Cases at the Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital in Yaoundé-Cameroon.
abstract: BACKGROUND
  More than 70 million couples suffer from infertility worldwide. The aim of this study was to evaluate the fertility outcomes after laparoscopic fimbrioplasty and neosalpingostomy in female infertility.
  
  
  METHODS
  Laparoscopic distal tuboplasty was carried out for 402 cases at the Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital in Yaoundé-Cameroon in Central Africa from December 2002 to December 2007. Laparoscopic fimbrioplasty and neosalpingostomy were done using bipolar electrocoagulation and conventional endoscopic instruments. Log-rank test was used to compare cumulative rate curves of intrauterine pregnancy with respect to the tubal stages. P<0.05 was considered statistically significant.
  
  
  RESULTS
  The mean age of the patients was 31.6±5.45 years. Secondary infertility was the most frequent type of infertility (70.14%). The laparoscopic tubal surgery done consisted of fimbrioplasty in 185(46%) cases and neosalpingostomy in 217 (54%) cases. Of 260 women followed up after tuboplasty, there were overall 74 (28.48%) pregnancies; 68(26.1%) intrauterine pregnancies and 6(2.3%) ectopic pregnancies. Pregnancy rates were significantly associated to the tubal stage (63% in stage 1, 15% in stage 3 and 00% in stage 4; p<0.001) and the adnexal adhesion scores (73.91% in the absence of adnexal adhesions and 8.8% in the case of a severe adnexal adhesion score). Of the 68 intrauterine pregnancies, there were 60(88%) live births and 8(12%) spontaneous abortions.
  
  
  CONCLUSIONS
  It is believed that laparoscopic fimbrioplasty and neosalpingostomy should be the preferred choice when faced with tubal distal occlusion in a context of female infertility. This implies that training in endoscopic surgery should be regarded as an important issue in developing countries.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Kasia
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Jean Dupont Kemfang
authors.initials: JD
authors.lastname: Ngowa
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
authors.forename: Yolande Salome
authors.initials: YS
authors.lastname: Mimboe
authors.affiliation: Laboratory of Clinical Biology, Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Michel
authors.initials: M
authors.lastname: Toukam
authors.affiliation: Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Anny
authors.initials: A
authors.lastname: Ngassam
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Claude Cyrile
authors.initials: CC
authors.lastname: Noa
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Etienne
authors.initials: E
authors.lastname: Belinga
authors.affiliation: Anesthesia Unit, Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
authors.forename: Alexis
authors.initials: A
authors.lastname: Medou
keywords: Adnexal adhesion; Fimbrioplasty; Infertility; Laparoscopy; Neosalpingostomy; Tubal stage