Takacs Peter, Chakhtoura Nahida
Jackson Memorial Hospital/University of Miami, Department of Obstetrics and Gynecology, Miami, Florida 33010, USA.
J Minim Invasive Gynecol. 2006 May-Jun;13(3):175-7. doi: 10.1016/j.jmig.2006.01.007.
To review the changing trends in the surgical management of ectopic pregnancy and to evaluate the effect of an ongoing training program for resident surgeons on the rate and success of laparoscopic surgery.
Retrospective chart review (Canadian Task Force classification II-3).
University tertiary medical center.
One thousand forty-six patients with ectopic pregnancy treated at Jackson Memorial Hospital from January 1, 1995, through December 31, 2004.
A formal, ongoing laparoscopic training program was established in 1999.
The rate of laparoscopy, laparotomy, and conversion for each year was compared with the baseline year of 1995 and between the years before and after the establishment of the training program.
Four hundred sixty-eight laparotomies and 578 laparoscopies were successfully completed. The laparoscopic approach rate has increased from 40.9% in 1995 to 86.3% in 2004. By year 2000 and thereafter, significantly more ectopic surgeries were approached through the laparoscope compared with in 1995 (p<.01). By 2000 and thereafter, significantly less conversions occurred compared with the baseline year of 1995 (4.0% vs 18.5%; p = .01).
Laparoscopy became the primary approach for the management of ectopic pregnancy in part because of resident participation in an ongoing laparoscopy training program.
回顾异位妊娠手术治疗的变化趋势，并评估一项针对住院外科医生的持续培训计划对腹腔镜手术率及成功率的影响。
回顾性病历审查（加拿大工作组分类II - 3）。
大学三级医疗中心。
1995年1月1日至2004年12月31日在杰克逊纪念医院接受治疗的1046例异位妊娠患者。
1999年设立了一项正式的、持续的腹腔镜培训计划。
将每年的腹腔镜检查率、剖腹手术率及中转率与1995年的基线年份进行比较，并在培训计划设立前后的年份之间进行比较。
成功完成了468例剖腹手术和578例腹腔镜手术。腹腔镜手术的实施率从1995年的40.9%上升至2004年的86.3%。到2000年及之后，与1995年相比，通过腹腔镜进行的异位妊娠手术显著增多（p<0.01）。到2000年及之后，与1995年的基线年份相比，中转率显著降低（4.0%对18.5%；p = 0.01）。
腹腔镜检查成为异位妊娠治疗的主要方法，部分原因是住院医生参与了一项持续的腹腔镜培训计划。
