Abstract: Objective：To explore the impact of pelvic adhesion on the fallopian tube recanalisation and the pregnancy outcomes of proximal and distal tubal surgery. Methods：The clinical data were collected from 1 038 patients who received hysteroscopic/laparoscopic examination and treatment in our hospital due to infertility. Those patients were divided into two groups according to the degree and scope of pelvic adhesion, the pelvic adhesion group included 738 cases and the control group included 300 cases without pelvic adhesion. The rates of proximal salpingemphraxis and distal fallopian tube recanalisation, and pregnancy outcomes, were analysed. Results：The incidence of distal tubal atresia in the pelvic adhesion group was higher than that in the control group （42.3% vs. 14.5%, P=0.000, OR=4.32, 95%CI：3.02－6.17）. There was no significant difference in the rate of proximal obstruction between the two groups （P＞0.05）. However, the rate of proximal tubal recanalisation in the pelvic adhesion group was lower than that in the control group （59.3% vs. 75.5%, P=0.005, OR=0.47, 95%CI: 0.28－0.80）. There was no significant difference in the rate of distal tubal recanalisation between the two groups （84.2% vs. 86.0%, P＞0.05）. The intrauterine pregnancy rate was lower in the pelvic adhesions group than that in the control group （22.6% vs. 39.6%, P＜0.001, OR=0.444, 95%CI: 0.282－0.698), while the incidence of postoperative ectopic pregnancy was higher in the pelvic adhesions group （7.2% vs. 2.7%, P=0.02）, especially in patients with degree Ⅲ adhesions （12.0% vs. 2.7%, P=0.01, OR=4.62, 95%CI: 1.29－16.50）. The incidence of pelvic adhesions was lower in patients who got intrauterine pregnant after distal tube occlusion only and proximal combined with distal surgery than that in patients who did not get pregnant （94.9% vs. 82.1%, 91.8% vs. 67.3%, P＜0.05). Conclusions：Pelvic adhesions reduce the rate of proximal tubal recanalisation, and the rate of intrauterine pregnancy in postoperative patients with distal salpingemphraxis. Pelvic adhesions also increase the long-term risk of ectopic pregnancy in those postoperative patients.

Key words: Pelvic inflammatory disease, Infertility, female, Fallopian tube obstruction, Laparoscopes, Hysteroscopes