Laparoscopic surgery in ectopic pregnancy

A randomized, prospective clinical trial was conducted to compare the efficacy of laparoscopic treatment versus conventional conservative abdominal surgery for tubal pregnancy.

Patients were stratified for age and risk determinants for ectopic pregnancy (EP). Forty-eight patients were treated by laparoscopy and 57 by laparotomy. Entry criteria were: size of the ectopic gestation < 4 cm, hemodynamic stability, accessibility for laparoscopic treatment and a trained laparoscopist on duty.

There was no difference between the groups regarding gestational duration, size and location of the ectopic gestation, and the mean preoperative hCG values. The groups did differ with respect to total operation time (73 min in the laparoscopy group vs. 88 min in the laparotomy group), hospital stay (2.2 days vs. 5.4 days) and convalescence period (11 days vs. 24 days). The rates of elimination of hCG were similar in the two groups, and there was no statistical difference in the rate of second intervention.

Patients treated by laparoscopy had a shorter hospital stay and a shorter convalescence than patients from the laparotomy group.