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Fallopian tube disease is one of the most common causes of infertility in women that results from tubal damage or obstruction. The American Society for Reproductive Medicine classification, based on scoring system of tubal changes verified by laparoscopy, is most widely used in practice. The aim of the paper is to determine the involvement and stage of hydrosalpinx and surgical therapy options in patients treated for marital infertility due to tubal factors during the preparation for in vitro fertilization after laparoscopy. In the two-year period, at the Clinic for Gyneacology and Obstetrics, Clinical Center Niš, 75 patients underwent videolaparoscopy to confirm previously established diagnosis of hydrosalpinx. Surgical treatment performed depended on the severity stage of hydrosalpinx. Removed Fallopian tubes were submitted for a histopathological analysis to the Institute of Pathology, Clinical Center Niš. An early stage hydrosalpinx was diagnosed by laparoscopy in 32 tubes. Out of them, tubal removal was performed in 9 tubes, and reconstructive surgery in 21. The most conspicuous changes were present in 46 Fallopian tubes. Surgical removal was performed in 41 tubes, occlusion of the isthmic portion of the tube was present in 5 tubes, and no reconstructive surgery was performed (significant correlation p <0.001 between the stage of hydrosalpinx and type of surgery). HP analysis of the removed Fallopian tubes revealed chronic inflammation in 84.27%. It is necessary to employ always the same, clear criteria in the diagnosis and to select properly the patients who will benefit from hydrosalpinx surgery, either tubal removal or reconstructive surgery. [ABSTRACT FROM AUTHOR]

Laparoscopic cholecystectomy (LC) has become the "gold standard" in the surgical treatment of gallbladder disease. However, in some cases LC needs conversion to open cholecystectomy (OC). Preoperative assessment that should determine in which patient conversion should be performed as well as identification of the risk factors for conversion are relatively difficult and imprecise. The aim of this study was to identify the risk factors for conversion of LC to OC. We performed the retrospective analysis of 65 patients, of both genders, with gallbladder disease, operated in the period from 01/01/2007 to 06/ 2013, in whom conversion of LC to OC was performed. A total of 1292 laparoscopic cholecystectomies (LCs) was done in this period. The authors analyzed: total conversion rate; the conversion rate according to patient characteristics (age, gender, body mass index (BMI)); local pathological condition (acute cholecystitis, chronic complicated cholecystitis, simple calculosis or gallbladder polyposis); surgeon-related parameters (number of performed LCs and total surgical experience). Total conversion rate (conversion of LC to OC) was 5,03%. Higher conversion rate was registered in the female patients (53.84%), but there were no statistically significant differences. The highest conversion rate was registered in the groups of patients in the 6th and 7th decade (p<0.05). Conversion rate was higher in patients with BMI>30 (6.56%), compared with those with lower BMI, but there was no statistical significance. Patients operated for acute cholecystitis had statistically significantly higher conversion rate (26.95 %), compared with those with the diagnosis of chronic simple cholecystitis (1.16 %), complicated chronic cholecystitis (8.46%), benign gallbladder polyposis (3.5%,) (p<0.05). Surgeons with a lower number of performed LCs (25-50) had higher conversion rate (12.67%), compared with experienced surgeons that performed over 200 LCs (1.4%) (p<0.05). Conversions are statistically significantly more present in older patients during surgery, in patients with the diagnosis of acute or complex chronic cholecystitis, and in those operated by inexperienced surgeons. Gender, high BMI, anatomical anomalies and variations, previous laparotomy or technical problems were not statistically significant conversion factors. [ABSTRACT FROM AUTHOR]