Hysteroscopically assisted laparoscopic salpingostomy in the treatment of tubal pregnancy

Česká verzia

Authors: R. Zaremba ¹; M. Mára ²; I. Razak ¹; V. Vlášek ¹
Authors place of work: Gynekologicko-porodnické oddělení Nemocnice Strakonice, primář MUDr. V. Vlášek ¹; Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. A. Martan, DrSc. ²
Published in the journal: Ceska Gynekol 2018; 83(1): 50-52

Summary

Objective:
To present a case of conservative – Fallopian tube preserving – surgical therapy of tubal pregnancy.

Design:
Case report.

Setting:
Department of Obstetrics and Gynecology, Strakonice Hospital.

Case description:
Due to the desire to preserve the Fallopian tube in a hemodynamically stable primigravida, we decided for laparoscopic salpingostomy using hysteroscopy for assisted removal of pregnancy tissue from the oviduct.

Conclusion:
In well-selected cases, this treatment is an effective method of choice and can be performed even under conditions of a smaller hospital performing a common spectrum of laparoscopic surgery.

Keywords:
tubal ectopic pregnancy, conservative treatment, salpingostomy, hysteroscopy

Zdroje

1. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94. Medical management of ectopic pregnancy. Obstet Gynecol, 2008, 111, p. 1479–1483.

2. Bangsgaard, N., Lund, CO., Ottesen, B., Nilas, L. Improved fertility following conservative surgical treatment of ectopic pregnancy. BJOG, 2003, 110, p. 765–70.

3. Bruhat, MA., Pouly, JL. Endoscopic treatment of ectopic pregnancies. Curr Opin Obstet Gynecol, 1993, 5(2), p. 260–266.

4. Calda, P., Břešťák, M., Fischerová D. Ultrazvuková diagnostika v těhotenství a gynekologii. 2. rozšířené a kompletně přepracované vyd. Praha: Aprofema., 2010, s. 428–434. ISBN 978-80-903706-2-3.

5. Canelas, CM., Shih, RD., Clayton, LM., et al. Repeat acute abdomen and hemoperitoneum during the same pregnancy due to a ruptured ectopic treated by salpingostomy. Am J Emerg Med, 201, 35(6), p. 942–943.

6. Derbak, A. Mimoděložní těhotenství v ultrazvukovém obraze. Kazuistiky. Retrospektivní analýza. Čes Gynek, 2016, 81, 1, s. 63–70.

7. Fujishita, A., Masuzaki, H., Khan, KN., et al. Laparoscopic salpingotomy for tubal pregnancy: comparison of linear salpingotomy with and without suturing. Hum Reprod, 2004, 19, p. 1195–1200.

8. Cheng, X., Tian, X., Yan, Z., et al. Comparison of the fertility outcome of salpingotomy and salpingectomy in women with tubal pregnancy: a systematic review and meta-analysis. PLoS One, 2016, 11, p. e0152343.

9. Jamard, A., Turck, M., Pham, AD., et al. Fertility and risk of recurrence after surgical treatment of an ectopic pregnancy: Salpingostomy versus salpingectomy. J Gynecol Obstet Biol Reprod, 2016, 45(2), p. 129–138.

10. Menon, S, Colins, J., Barnhart, KT. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril, 2007, 87, p. 481–484.

11. Mol, F., van Mello, NM., Strandell, A., et al. Salpingotomy versus salpingectomy in women with tubal pregnancy (European surgery in ectopic pregnancy study): An openlabel, multicenter, randomized controlled trial. Lancet, 2014, 383, p. 1483–1489.

12. Tulandi, T. Ectopic pregnancy: Choosing a treatment and methotrexate therapy [online]. 2017 Apr 10 2016 [cit. 2017-08-10]. Dostupné z: https://www.uptodate.com/contents/ectopic-pregnancy-choosing-a-treatment-and-methotrexate-therapy.

13. Tulandi, T. Ectopic pregnancy: Incidence, risk factors, and patology [online]. 2016 [cit. 2017-08-10]. Dostupné z: https://www.uptodate.com/contents/ectopic-pregnancy-incidence-risk-factors-and-pathology.