Laparoscopic tube-preserving surgical procedures for ectopic tubal pregnancy.
10.5468/ogs.2016.59.6.512
- Author:
Taejong SONG
1
;
Dong Hee LEE
;
Hwa Cheung KIM
;
Seok Ju SEONG
Author Information
1. Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. taejong.song@gmail.com
- Publication Type:Original Article
- Keywords:
Ectopic pregnancy;
Salpingectomy;
Salpingostomy;
Tubal pregnancy
- MeSH:
Chorionic Gonadotropin;
Female;
Hemorrhage;
Hemostasis;
Humans;
Hysterosalpingography;
Milk;
Outcome Assessment (Health Care);
Postoperative Complications;
Pregnancy;
Pregnancy, Ectopic;
Pregnancy, Tubal*;
Prospective Studies;
Salpingectomy;
Salpingostomy;
Trophoblasts
- From:Obstetrics & Gynecology Science
2016;59(6):512-518
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. METHODS: This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates. RESULTS: Of the 57 surgical procedures, 55 (96.4%) were performed successfully without any additional intervention. The number of patients receiving salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking were 24 (42.1%), 25 (43.9%), 4 (7.0%), and 2 (3.5%), respectively. Two case was switched to salpingectomy because excessive bipolar coagulation was required to obtain hemostasis at the tubal bleeding bed. Over a mean β-human chorionic gonadotropin resolution time of 18.3±5.9 days, no persistent trophoblast or postoperative complications occurred. A tubal patency test using hysterosalpingography was performed in 15 cases at 3 months postoperatively. Among these, the homolateral tubal patency rate was 75% (11 of 15) and the contralateral patency rate was 80% (12 of 15). CONCLUSION: Tube-preserving surgery is a feasible and safe treatment option for ectopic tubal pregnancy. However, considering that the optimal goal of tube-preserving surgical procedures is not the treatment success, some caution is warranted in interpreting results of this study.
