Study of role of minimally invasive surgeries in the management of ectopic pregnancy

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Study of role of minimally invasive surgeries in the management of ectopic pregnancy

Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 10

Abstract

Introduction: Ectopic pregnancy (EP) can be defined as the implantation of the fertilized ovum at any site other than normal endometrial cavity. The incidence is gradually increasing from 0.5 to 2 per 100 pregnancies. The incidence of EP is increasing worldwide and it reflects an increase in awareness and availability of effective early diagnostic facilities. Incidence varies from country to country and from situation to situation (spontaneous versus assisted pregnancies). Aims and Objective: To study the effectiveness of minimally invasive surgery; Laparoscopy over Laparotomy in ectopic pregnancy. Methodology: This was a hospital based, prospective clinical trial, after approval from the institutional ethical committee, all the patients which suspected as Ectopic pregnancy were diagnosed by the Ultrasonography and Other Hormonal method like Beta HCG level were used to confirm the diagnosis, after confirmation, written consent of the patients or patients relatives were taken then these patients were randomly allotted to Laparoscopy or Laparotomy with 15 patients each in the group ;Total 30. These patients were followed intra-operatively and Post-operatively. The Data was analyzed by unpaired t-test, and z-score by Graph Pad Prism-6. Result: Average age was 26±2.1Yrs. in Laparoscopy and 27± 3.2 Yrs. Laparotomy this difference was not statistically significant, Average Operative time for Laparoscopy was 55± 8.2min and for Laparotomy 38± 5.2min. Which was significantly higher in Laparoscopy (P< 0.0001, t = 6.780, df = 28). Intra-operative bleeding in Laparoscopy was 200±10.5ml and Laparotomy was 500ml±15.3ml (P< 0.0001; t =64.45; df=28); Average hospital stay for Laparoscopy was 3 ±2 Days and for Laparotomy was 6± 3Days Which was statistically significant (P<0.0001; t =3.22; df=28); Average Analgesic required (No. of Tab.) Laparoscopy 10±3 Tabs and 18±4Tabs. For the Laparotomy Which was statistically significant (P<0.0001 ;t = 6.19; df=28); Wound healing (Days) for Laparoscopy 12±2 Days and for Laparotomy was 21±3Days Which was statistically significant (P< 0.0001; t = 9.67; df=28).Overall the 2 (13.33%) complications occurred in Laparoscopy i.e. Wound infection and Mild transfusion reaction while 9(60.00%) complications occurred in Laparotomy group i.e. Wound infection, Mild transfusion reaction, Severe transfusion reaction, Septicemia this observed difference was statistically significant (P<0.0001; Z-score = 2.65). Conclusion: Except average more operative time is required for the laparoscopy compared to Laparotomy; overall the minimally invasive surgery laparoscopy is superior in m any ways like less Intraoperative blood lost,less analgesia is required and less complications and less time required for the wound healing.

Authors and Affiliations

G P Sekar, K G M Premaleela, T Deepu, K Madhu Mitha

Keywords

EP ID EP193790
DOI -
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