Treatment Outcomes of Ectopic Pregnancy by Laparoscopy vs Laparotomy: a Retrospective Cohort Study

Abstract

Objectives: To compare the type of tubal operative procedure, operative time, and postoperative outcomes in patients undergoing laparoscopic surgery versus laparotomy for the treatment of ectopic pregnancy.

Methods: A retrospective cohort study was conducted in patients who had ectopic pregnancy and were treated in Faculty of Medicine Vajira Hospital from 1 January 2005 to 31 December 2009. Ninety-eight patients were recruited into the study. Of these, 49 patients were treated by laparoscopic surgery and 49 by laparotomy. Demographic and operative data were collected from the medical records and were compared between the two groups.

Results: Salpingostomy was more commonly performed in the laparoscopic group (55.1%) while salpingectomy was the main procedure in the laparotomy group (63.3%). Operative time was longer by laparoscopic approach compared to laparotomy (115.3 ± 20.2 mins vs 67.1 ± 14.4 mins, p-value < 0.001). Lower visual analogue postoperative pain score (2.4 ± 1.2 vs 6.0 ± 1.0, p-value < 0.001), less postoperative analgesics requirement in the first 24 hours (1.2 ± 1.0 doses vs 4.0 ± 1.0 doses, p-value < 0.001), and shorter hospital stay (2.1 ± 0.3 days vs 3.5 ± 0.4 days, p-value < 0.001) were found in laparoscopic surgery group in comparison to those in the laparotomy group.

Conclusion: Tubal preservative procedure was done more frequently in the laparoscopic group. Laparoscopy has benefits over laparotomy in terms of lower postoperative pain score, less needed for analgesics, and shorter hospital stay.