Surgical treatment of ectopic pregnancy associated with predisposing factors of tuboperitoneal infertility

被引:4
作者
Calcagno, Angelo [1 ,2 ]
Londero, Ambrogio P. [1 ]
Haag, Thierry [2 ]
Driul, Lorenza [1 ]
Bertozzi, Serena [3 ]
Grassi, Tiziana [1 ]
Marchesoni, Diego [1 ]
Manhes, Hubert [2 ]
机构
[1] AOU SM della Misericordia, Clin Obstet & Gynecol, Udine, Italy
[2] Private Clin La Pergola, Serv Obstet & Gynecol, Vichy, France
[3] AOU SM della Misericordia, Dept Surg, Udine, Italy
关键词
Ectopic pregnancy; infertility surgery; laparoscopy; CONSERVATIVE LAPAROSCOPIC TREATMENT; FERTILITY; SURGERY; MANAGEMENT; DIAGNOSIS;
D O I
10.3109/13645706.2012.708346
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: We sought to study the advantages of laparoscopic conservative treatment and pelvic reproductive surgery in patients with ectopic pregnancy and predisposing factors of tuboperitoneal infertility. Material and methods: Patients who had undergone laparoscopic treatment for ectopic pregnancy were considered, with factors for tuboperitoneal infertility, while patients who underwent previous salpingectomy or assisted reproductive technology were excluded. The groups treated by salpingotomy (conservative) or salpingectomy (radical) were compared in terms of spontaneous intrauterine pregnancy rate, cumulative one-year pregnancy rate and recurrence of ectopic pregnancy. We considered patients treated with adhesiolysis, fimbrioplasty, and neosalpingostomy for tubal pathology as part of the fertility surgery group. Results: Among 41 considered patients, 21 (51%) underwent conservative laparoscopic management of ectopic pregnancy. Twenty patients (49%) had salpingectomy. Despite the treatment of tuboperitoneal infertility factors in both groups, the pregnancy rate was significantly higher in the conservative group than in the radical one (76% vs 25%, p < 0.05). The overall cumulative rate of ectopic pregnancy recurrence was 22% and no significant difference was found between conservative and radical treatment (p 0.645). Conclusions: Salpingotomy should be preferred in all patients with ectopic pregnancy associated with factors of tuboperitoneal infertility. Infertility surgery clearly cannot help patients treated with salpingectomy, who obtain lower spontaneous pregnancy rates than those of the conservative group.
引用
收藏
页码:97 / 103
页数:7
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