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AI InsightBulgular: Ektopik gebelik tanısı alan 80 hastanın 65'ine (%81.25) laparotomi, 15'ine (%18.75) laparoskopi yapıldı.
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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.
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.