Contrast analysis of different laparoscopic surgical treatments for tubal pregnancy outcome and repregnancy / 中国医师进修杂志

ABSTRACT

ObjectiveTo investigate the outcome and repregnancy after different laparoscopicsurgical treatments for tubal pregnancy,and analyse the influential factors. MethodsIn 56 tubal pregnancypatients,28 cases performed laparoscopic salpingostomy (group A) and 28 cases peoformed laparoscopicsalpingectomy (group B). The perioperative condition, the rate of repregnancy and re-ectopic pregnancy was compared and analyzed. Logistic regression analysis was used to detect the effect on subsequent repregnancyof influential factors such as pelvic adhesion. ResultsMore bleeding and longer operative time were needed in group A than group B, there were significant differences between two groups (P ＜ 0.05 ). In follow-up of 6months to 6 yeats,the rate of repregnancy in group A and group B was 46.4％(13/28) and 32.1％(9/28)respectively,there was no significant difference between two groups (P ＞0.05). The rate of re-ectopic pregnancy in group A and group B was 10.7％ (3/28) and 28.6％ (8/28) respectively,there was significant difference between two groups (P ＜0.05). In the single factor analysis,the repregnancy in group A was significantly associated to pelvic adhesion and patency of the contralateral oviduct (P ＜ 0.05 ). Conclusions The rate of repregnancy of laparoscopic salpingostomy is higher than laparoscopic salpingectomy for tubal pregnancy. Each of pelvic adhesion and the patency of the contralateral oviduct is a factor that affects the postoperative fertility. The conservation operation is not recommended for those patients with extensive pelvic adhesion or seriously destroyed tube but normal contralateral oviduct.