Wenjing Lin, Haibo Li
Department of Obstetrics, Baoji Central Hospital, Baoji, China.
Front Surg. 2022 Oct 11;9:997490. doi: 10.3389/fsurg.2022.997490. eCollection 2022.
Laparoscopic treatment of ectopic pregnancy mainly includes laparoscopic salpingotomy and salpingectomy. We aimed to assess the therapeutic effect of laparoscopic salpingotomy and salpingectomy on patients with tubal pregnancy.
From January 2000 through June 2022, the Cochrane Library, Medline, PubMed, Web of Science, EMBASE, and the Chinese Biomedicine Database were searched for studies that compared the therapeutic effect of laparoscopic salpingotomy vs. salpingectomy in the treatment of tubal pregnancy.
Twenty-four randomized clinical trials (RCTs) studies were incorporated into this analysis. No statistical differences were found between the two groups in terms of operation duration and postoperative hospitalize length, but the volume of intraoperative blood loss in patients with laparoscopic salpingotomy was less than that in salpingectomy. Importantly, the natural intrauterine pregnancy rate after laparoscopic salpingotomy was significantly higher than those who underwent salpingectomy. In addition, laparoscopic salpingotomy can better protect the ovarian reserve function and endocrine function and provide favorable conditions for the second pregnancy.
Patients with ectopic tubal pregnancy should give priority to laparoscopic salpingotomy for embryo extraction.
腹腔镜治疗异位妊娠主要包括腹腔镜输卵管切开取胚术和输卵管切除术。我们旨在评估腹腔镜输卵管切开取胚术和输卵管切除术对输卵管妊娠患者的治疗效果。
检索2000年1月至2022年6月期间的Cochrane图书馆、Medline、PubMed、科学网、EMBASE和中国生物医学数据库，查找比较腹腔镜输卵管切开取胚术与输卵管切除术治疗输卵管妊娠疗效的研究。
本分析纳入了24项随机临床试验（RCT）研究。两组在手术时长和术后住院时间方面未发现统计学差异，但腹腔镜输卵管切开取胚术患者的术中失血量少于输卵管切除术患者。重要的是，腹腔镜输卵管切开取胚术后的自然宫内妊娠率显著高于接受输卵管切除术的患者。此外，腹腔镜输卵管切开取胚术能更好地保护卵巢储备功能和内分泌功能，为再次妊娠提供有利条件。
输卵管异位妊娠患者应优先选择腹腔镜输卵管切开取胚术取出胚胎。
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