Treatment of 187 cases of tubal pregnancy by laparoscopic surgery / 中国微创外科杂志

ABSTRACT

Objective To explore the procedure selection of laparoscopic surgery in the treatment of tubal pregnancy.Methods A total of 187 patients with tubal pregnancy was treated either by laparoscopic salpingectomy(102 patients,Group Ⅰ) or by laparoscopic oviduct fenestration(85 patients,Group Ⅱ). Results The surgical time was 40.4?9.9 min in the Group Ⅰ and 88.8?10.3 min in the Group Ⅱ.The intraoperative blood loss was 17.7?5.4 ml in the Group Ⅰ and 80.6?4.4 ml in the Group Ⅱ.The postoperative hospital stay was 3.8?0.5 d in the Group Ⅰ and 7.4?0.9 d in the Group Ⅱ.The postoperative time to normal serum ?-hCG levels was 7~14 d in the Group Ⅰ and 10~33 d in the Group Ⅱ.A follow-up was carried out in 116 patients.No recurrence of ectopic pregnancy happened in the Group Ⅰ(60 patients).In the Group Ⅱ(56 patients),hydrotubation or salpingography revealed patent oviduct in 37 patients,intrauterine pregnancy in 25 patients,and recurrence of tubal pregnancy at the same side in 2 patients. Conclusions Salpingectomy should be the first choice in the treatment of tubal pregnancy because of its short surgical time,short hospital stay,less intraoperative blood loss,and low complication incidence.Oviduct fenestration should be conducted only for patients with child-bearing demands,but we must be on our guard against the possibility of persistent ectopic pregnancy,and a salpingectomy or a conversion to open surgery should be performed immediately once the bleeding can not be stopped effectively during the operation.