Misdiagnosis of Old Ectopic Pregnancy：Report of Two Cases / 中国微创外科杂志

[Summary] From February 2008 to June 2008, two cases of old ectopic pregnancy were misdiagnosed: Case 1 was misdiagnosed as gestational trophoblastic disease (GTD), and Case 2 was misdiagnosed as cornual pregnancy.In order to further confirm the diagnosis, two cases were all given laparoscopic exploration.Surgery confirmed interstitial chronic ectopic pregnancy, leading to a resection of the fallopian tubes and mass lesions.Embryo tissue was pathologically confirmed postoperatively.The diagnosis of old ectopic pregnancy is difficult.Serum hCG determination is often found no positive, and ultrasound examination has no specificity.The clinical images are varied.Detailed medical history inquiry and attention to differential diagnosis are key for the diagnosis of old ectopic pregnancy.

Laparoscopic operation in the treatment of interstitial tubal pregnancy / 中国微创外科杂志

Objective To study the clinical value of laparoscopic operation in the treatment of interstitial tubal pregnancy. Methods Clinical data of 21 cases of interstitial tubal pregnancy treated by laparoscopic operation were retrospectively studied. Results Operations in all the 21 cases were conducted successfully,without conversions to open surgery and intra- or post- operative complications.The operation time was 25 ～ 90 min (mean,40 min),and the postoperative hospital stay was 3 ～ 6 d (mean,4.5 d). Conclusions Laparoscopic operation for the treatment of interstitial tubal pregnancy is feasible.

Laparoscopic Treatment for Interstitial Tubal Pregnancy:a Simple,Quick,and Safe Method / 中国微创外科杂志

Objective To evaluate the efficacy of laparoscopic treatment for interstitial tubal pregnancy. Methods A total of 12 cases of interstitial tubal pregnancy underwent laparoscopy in our hospital from 1993 April to June 2007. Among the patients,9 received tubal ligation using lasso (1-0 suture were used during the surgery and the fetal tissues were removed at the same time),1 underwent salpingotomy to remove the fetus,1 were treated by salpingectomy using stapling device,and 1 received injection of MTX (40 mg). Results The procedure was completed within 30-120 minutes. The intraoperative blood loss was ≤20 ml in all of the cases,except one who received salpingectomy (200 ml). In 10 patients,the level of blood hCG decreased to a normal range in 2 weeks,while the other two cases recovered in 4 and 8 weeks respectively postoperation. Conclusion Laparoscopic treatment is safe and effective for interstitial tubal pregnancy.

Laparoscopic Ligation and Resection for Interstitial Tubal Pregnancy / 中国微创外科杂志

Objective To study the efficacy of laparoscopic ligation and resection for the treatment of interstitial tubal pregnancy.Methods Totally 32 patients with interstitial tubal pregnancy were enrolled into this study.The cases were randomly divided into groups A and B(16 in each).Laparoscopic ligation and resection was performed in group A,while the patients in group B received traditional salpingectomy to remove the embryo after local electrical coagulation.The operation time,intraoperative blood loss,rates of conversion to open surgery and postoperative complications,the 24-hour change of ?-hCG,and the recovery time of ?-hCG level were compared between the two groups.Results Compared to the group B,group A had significantly shorter operation time and less blood loss (40?16)min vs(60?19)min,t=-3.178,P=0.004;and(40?12)ml vs(95?26)ml,t=-7.644,P=0.000].The 24-hour change and recovery time of the level of ?-hCG were similar between the two groups (9889?7945)mIU/ml vs(9696?7883)mIU/ml,t=0.068,P=0.946;(10.1?3.2)d vs(9.8?2.4)d,t=0.294,P=0.771].Conclusions Laparoscopic ligation and resection is effective for the treatment of interstitial tubal pregnancy.