Laparoscopic management of ectopic pregnancy in the presence of a significant haemoperitoneum

Rizzuto, M. I.; Oliver, Reeba; Odejinmi, Funlayo

doi:10.1007/s00404-007-0473-7

Cited by 18 publications

(13 citation statements)

References 11 publications

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“…Although haemodynamically unstable patients were excluded from this study, there is enough evidence to suggest that laparoscopic surgery can be safely performed in these women. [11,12,19] Secondary and tertiary public hospitals should invest in skills training, laparoscopic equipment and instruments to enable laparoscopic surgery for women presenting with ectopic pregnancy. Operative laparoscopy on a 24-hour basis for the treatment of women with REP is feasible in a public hospital in resource-poor settings and should become standard treatment for the majority of women with this condition.…”

Section: Resultsmentioning

confidence: 99%

“…[5][6][7] However, the laparoscopic approach was superior to laparotomy in terms of significantly shorter operating time, [6,7] reduced intraoperative blood loss, analgesic requirement, time to normal activity, total hospital costs, [8] shorter hospital stay and quicker recovery in haemodynamically stable women. [9] Although some data suggest that laparoscopic surgery is feasible in women with significant haemoperitoneum, [10][11][12][13] to our knowledge there are no prospective randomised trials comparing laparotomy with laparoscopy in the surgical management of women with REP in any setting. The available evidence of the preferred mode of surgical treatment for women diagnosed with suspected REP is scanty and consists of retrospective trials, mostly with small numbers.…”

Section: Researchmentioning

confidence: 99%

“…[10][11][12][13] Regression analysis accounting for the learning curve shows that laparoscopic surgery requires longer operating time; this is a feature of the procedure and not exclusively operator dependent. In this study, operating time was significantly longer for laparoscopic surgery compared with laparotomy.…”

Section: Researchmentioning

confidence: 99%

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A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy

2017

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Background. Ruptured ectopic pregnancy (REP) is a common gynaecological emergency in resource-poor settings, where laparotomy is the standard treatment despite laparoscopic surgery being regarded as the optimal treatment. There is a lack of prospective randomised data comparing laparoscopic surgery with laparotomy in the surgical management of women with REP. Objective. To compare operative laparoscopy with laparotomy in women with REP. Methods. This was a randomised parallel study. One hundred and forty women with suspected REP were randomised to undergo operative laparoscopy or laparotomy. The outcome measures were operating time, hospital stay, pain scores and analgesic requirements, blood transfusion, time to return to work, and time to full recovery. Results. Operating time was significantly longer in the laparoscopy group (67.3 v. 30.5 minutes, p<0.001). Duration of hospital stay, pain scores and need for analgesia were significantly less in the laparoscopy group. Women in this group returned to work 8 days earlier and their time to full recovery was significantly shorter compared with those in the laparotomy group. Significantly more women undergoing laparotomy required blood transfusion than women in the laparoscopy group. In the latter group, 14.5% of women required blood transfusion compared with 26.5% in the laparotomy group (p=0.01). Conclusion. Operative laparoscopy in women treated for REP is feasible in a resource-poor setting and is associated with significantly less morbidity and a quicker return to economic activity.

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Section: Resultsmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

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A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy

2017

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“…In a study spanning twelve years and 19 cases in one institution, primary laparoscopy was attempted in 84% of women with ovarian pregnancy . Another study reported that in 2006, all women with an ectopic pregnancy and significant haemoperitoneum were successfully treated laparoscopically …”

Section: Discussionmentioning

confidence: 99%

Successful diagnosis and laparoscopic management of haemorrhagic ovarian pregnancy with haemorrhagic contralateral corpus luteum

Tambimuttu

Lott

Moore

2015

Aust NZ J Obst Gynaeco

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“…Furthermore, minimally invasive management has been widely accepted as having various benefits and become the trend for management [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Management of Interstitial Ectopic Using Simple and Safe Technique: Case Series and Review of Literature

Said

2016

J Obstet Gynecol India

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Background and Objective To determine the safety and sustainability of operative laparoscopy in surgical management of cornual and interstitial ectopic pregnancy using a simple and practical method. Design Case series of five consecutive cases.Setting Endoscopy unit in Alexandria University Hospital and Alexandria New Medical Center. Patients Between July 2013 and May 2015, five women with interstitial and cornual ectopic pregnancies were admitted for laparoscopic surgical treatment. Methods Full medical and surgical histories were taken. We explained all alternatives for both partners before informed. Patients underwent laparoscopy for management of the corneal ectopic. All surgeries were done by the same surgeon (T.S.) with different assistants. We gave different uterotonics drugs to devascularize the uterus. Two or more devascularization sutures were done on each end of the corneal ectopic. We used monopolar and bipolar electrocoagulation when indicated. We did linear cut of the interstitial ectopic with evacuation of the fetus and placental tissues. Extraction of the conceptus was performed through 10 mm port. Follow-up of the beta-hCG was done weekly till negative results were obtained.

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Laparoscopic management of ectopic pregnancy in the presence of a significant haemoperitoneum

Abstract: Our study demonstrates that with highly skilled anaesthetic and surgical teams, operative laparoscopy with its recognized advantages over laparotomy and is feasible in women with ruptured ectopic pregnancy and significant haemoperitoneum.

Cited by 18 publications

References 11 publications

A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy

A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy

Successful diagnosis and laparoscopic management of haemorrhagic ovarian pregnancy with haemorrhagic contralateral corpus luteum

Laparoscopic Management of Interstitial Ectopic Using Simple and Safe Technique: Case Series and Review of Literature

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