Use of laparoscopy in the diagnosis and treatment of ectopic pregnancy / 中国微创外科杂志

ABSTRACT

Objective To explore the value of laparoscopy in the diagnosis and treatment of ectopic pregnancy.Methods Laparoscopy was performed in 342 cases suspected of having ectopic pregnancy.If the confirmative diagnosis was clarified,unilateral salpingectomy,salpingostomy,ovarian wedge resection,or cornual resection were conducted;if the diagnosis was not clearly established under laparoscope,further evaluation with dilation and curettage was given.Results Out of 342 cases,335 were confirmatively diagnosed as having ectopic pregnancy under laparoscope,333 of which were successfully treated by laparoscopy(including 3 cases of ovarian pregnancy and 3 cases of interstitial pregnancy) and 2 of which were given conversions to open surgery.Among 7 cases in which the diagnosis was not clearly established under laparoscope,1 case was diagnosed as having intrauterine pregnancy with uterine anomaly(unicornuate uteri with rudimentary horn) and was treated with cornual resection and homolateral salpingectomy,1 case was diagnosed as having intrauterine pregnancy accompanying corpus luteal rupture and was treated with enucleation of corpus lutein cyst,and other 5 cases were not found having intrauterine or ectopic pregnancy and were cured with MTX injection.The time to first flatus was 8~24 hours after laparoscopic operation in 340 cases and 24~36 hours after open surgery in 2 cases.The duration of postoperative hospital stay was 2~4 days after laparoscopy except for 5 cases of MTX therapy,and 6 days after open surgery.Conclusions Laparoscopy is valuable in the early diagnosis of ectopic pregnancy;laparoscopic operation is safe and effective in the treatment of ectopic pregnancy.