Journals / Medical Network Klinik Bilimler ve Doktor / 2004 / Cilt: 10 - Sayı: 4
Surgical approach to ectopic pregnancies
- Pages
- 449–452
- DOI
- —
Abstract
Objective: Our goal is to determine the factors that affect the surgeons' choice between laparotomy and laparoscopy for the surgical therapy of ectopic pregnancies. Materials and Methods: A retrospective study was performed to the case of ectopic pregnancies from August 1998 through August 2002. The laparotomy and laparoscopy surgical treatment groups were compared with the use of student t test. Results: The database included 80 cases. The sixtyfive cases (%81.25) had been treated with laparotomy and while the rest fifteen (%18.75) had been treated with laparoscopically. When compared, the rate of acute abdomen was significantly higher in laparotomy group (%90.76 59/65 laparotomy group-%33.33 (5/15) laparoscopy group, p<0.01); the rate of the cases with hemoperitonium was also significantly higher in laparotomy group (%84.61 55/65 laparotomy group- %33.33 5/15 laparoscopy group, p<0.01). The rate of cases that had a hCG level of >1500 IU/ml was significantly higher in laparotomy group (%83.07 54/65 laparotomy group- %33.33 5/15 laparoscopy group, p<0.01). The rate of cases that had a ectopic pregnancy mass diameter of >4cm was significantly higher in laparotomy group (%96.92 63/65 laparotomy group- %40.0 6/15 laparoscopy group, p<0.01). The percent of cases with ampuller tubal ectopic pregnancies was %70.76 (46/65) for the laparotomy and %86.66 (13/15) for the laparoscopic cases; and the differences between two groups was not significant (p>0.01). Also the percent of cases with extirpative surgery was %89.23 (58/65) for the laparotomy and %60.0 (9/15) for the laparoscopic cases; and the differences between two groups was not significant either (p>0.01). Conclusion: At the ectopic pregnancy cases, the surgeons' choise between laparotomy and laparoscopy depends on the hemodynamic stability of the patient, diameter and localization of ectopic pregnancy mass, and surgeons' experience.
Özet
Amaç: Ektopik gebelik vakalarında cerrahi tedavisinde, cerrahın laparotomi veya laparoskopi seçimini etkileyen faktörlerin analizi. Gereç ve Yöntem: 1998 Ağustos-2002 Ağustos tarihleri arasında kliniğimizde ektopik gebelik tanısıyla laparotomi ve laparoskopi yapılan tedavi gruplarının, retrospektif olarak, bağımsız örneklerde iki yüzde arasındaki farkın önemlilik t testi ile karşılaştırılması. Bulgular: Ektopik gebelik tanısı alan 80 hastanın 65'ine (%81.25) laparotomi, 15'ine (%18.75) laparoskopi yapıldı. Laparotomi yapılan vakaların %90.76'sında (59/65), laparoskopi yapılanların ise %33.33'ünde (5/15) akut batın tespit edildi (p 4cm olanların oranı %96.92 (63/65), laparoskopide ise %40 (6/15) idi (p 0.01). Yine laparotomide %89.23 (58/65), laparoskopide ise %60 (9/15) oranında ekstirpatif cerrahi uygulandı (p>0.01). Sonuç: Ektopik gebeliklerde laparotomi veye laparoskopi şeklindeki cerrahi tedavi metodu seçimi hastada hemoperitonyum varlığı, ektopik gebelik kitlesinin çapı ve lokalizasyonu, ve de cerrahın tecrübesine bağlıdır.