Laparoscopic operations in gynecologic emergency / 中国微创外科杂志

ABSTRACT

Objective To investigate the clinical significance of laparoscopic operations in gynecologic emergency. Methods We retrospectively analyzed 145 cases of gynecologic emergency dealt with laparoscopic operations in May 1997～August 2001. Out of the 145 cases, tubal pregnancy accounted for 100 cases (Laparoscopy Group), which were further compared with 89 cases of tubal pregnancy in January 1994～April 1997 treated by open operations (Open Group). Results Out of the 145 operations, 139 (95.9%) were successfully carried out under laparoscope, with the conversion to open operations in 6 cases. There were 61 cases of salpingectomy, 28 cases of oviduct fenestration, 11 of fenestration converting into salpingectomy, 16 of partial ovariectomy, 8 of adnexectomy for ovarian cyst pediculotorsion, 4 of cyst resection, 3 for rupture of endometrial cyst of ovary, 6 for pelvic abscess and 2 for pelvic encapsulated fluid. Compared with the Open Group, the Laparoscopy Group had longer length of surgical intervention (t=3.9, P=0.000) and more intraoperative blood loss (t=5.8, P=0.000). Conclusions Laparoscopic operations play double actions both in diagnosis and in treatment for most gynecologic emergencies, being a safe and reliable approach. Laparoscopic salpingectomy (non-oviduct-sparing operations), however, should be chosen for urgent patients.