Saratov JOURNAL of Medical and Scientific Research

Comparative analysis of efficiency of two techniques of endoscopic organ sparing surgery at ectopic tubal pregnancy

Year: 2019, volume 15 Issue: №1 Pages: 14-18
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Fetisheva L.E., Mozes V.G., Mozes K.B.
Organization: Kemerovo State Medical University

Aim: to compare the effectiveness of salpingostomy with the subsequent evacuation of the ovum and the resection of a part of the ampulla of the fallopian tube with the ovum and the subsequent neostomatoplasty in the treatment of tubal pregnancy. Material and Methods. A retrospective randomized study of the effectiveness of two techniques of endoscopic organ-sparing surgical treatment of ectopic tubal pregnancy was conducted. Results. The time for performing salpingostomy and resection was 11.8±1.5 minutes and 21±2 minutes, respectively (U[12458]=0, p=0.001). Compared with salpingostomy, the thread did not lead to the appearance of a trophoblast, which was accompanied by a decrease in the degree of adhesions in the pelvis in the third month of observation (PAI showed 2 (2; 2) and 0 (0; 1) points, respectively U =759, p=0.001; R-AFS corresponded to the minimum degree of severity: 2(0; 2) and 0 (0; 0) points, respectively (U4 =1076, p=0.001); according to the modified classification of the degree of adhesions in the pelvis after cesarean section corresponded to the minimum degree of severity: 4 (0;4) and 0 (0;4) points, respectively (U[12458]=2617, p=0.006)and more frequent the operated fallopian tube (30.6% and 58,6%, respectively, p=0.001)was accompanied by a more frequent onset of spontaneous uterine pregnancy by the 12th month of observation (12.9% and 29,3%, respectively, p=0.007) and delivery to 18 months of observation (3.2% and 15.5%, respectively, p=0.001). Conclusion. Despite the higher technical complexity, resection of a part of the ampulla of the fallopian tube with a fetal egg and subsequent neostomatoplasty is an effective alternative to salpingostomy andmay be used in women with an ectopic pregnancy wishing to preserve reproductive function.

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