Comparison of three conservative laparoscopic procedures in treatment of tubal pregnancy
10.3760/cma.j.cn114798-20191024-00789
- VernacularTitle:三种保守性腹腔镜手术方法治疗输卵管妊娠的疗效比较
- Author:
Guanghua CHU
1
;
Chen LIU
;
Chunyan HU
;
Kun YAN
Author Information
1. 西北妇女儿童医院妇科，西安 710061
- From:
Chinese Journal of General Practitioners
2020;19(6):512-516
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical effects of three laparoscopic conservative surgical procedures for tubal pregnancy.Methods:From January 2016 to June 2017, 296 patients with tubal pregnancy who underwent laparoscopic fallopian tube window embryo retrieval in our hospital were included in the study. Ninety six patients received meshmental suture combined with tubal incision and suture (group A), 102 patients receive mesentery suture (group B) and 98 patients received conventional surgery (group C). All patients in the three groups were given methotrexate 25 mg injected to the mesentery of the fallopian tube after surgery. The general conditions, treatment effects and postoperative conditions of the three groups were compared. Statistical analysis was performed using analysis of variance or χ 2 test. Results:There was no significant difference in general conditions among the three groups ( P>0.05). The surgical success rate of groups A and B were significantly higher than that of the group C [99.0%(95/96),99.0%(101/102),93.9%(92/98);χ 2=6.52, P=0.04]; the intraoperative blood loss of groups A and B was significantly lower than that in the group C [(30.6±10.9)ml, (30.9±11.6)ml, (63.5±21.8)ml; F=144.18, P<0.01]. At three months after operation, the tubal patency (patency, tortuous, obstruction) of the affected side of the group A was significantly better than that of the groups B and C [group A:81.1%(77/95),13.7%(13/95),5.3%(5/95); group B: 62.4%(63/101),21.8%(22/101),15.8%(16/101);group C:55.4%(51/92),26.1%(24/92),18.5%(17/92); χ 2=15.64, P<0.01]. Eighteen months after surgery, the fallopian pregnancy rate and secondary infertility rate of the affected side of the tubal in group A were significantly lower than those in groups B and C [group A:7.3%(7/96) and 12.5%(12/96),group B: 17.6%(18/102) and 21.6%(22/102), group C: 19.4%(19/98) and 28.6%(28/98); χ 2=6.56, P=0.04; χ 2=7.60, P=0.02]. The intrauterine pregnancy rate of tree groups was similar [45.8%(44/96),35.3%(36/102),33.7%(33/98); χ 2=3.59, P=0.17]; none of the patients in the three groups had persistent ectopic pregnancy, and no serious adverse reactions occurred during treatment. Conclusions:Laparoscopic salpingotomy and tubal incision and laparoscopic suture combined with tubal incision suture are easy to be performed with less bleeding, high surgical success rate and high recanalization rate of fallopian tubes, which deserves clinical promotion.
