Fertility outcomes after laparoscopic salpingectomy or salpingotomy for tubal ectopic pregnancy: A retrospective cohort study of 95 patients.

OBJECTIVE

This study presents our experience with laparoscopic surgery for tubal ectopic pregnancy (EP), sums up the different features of two commonly utilized laparoscopic surgeries, and compares subsequent post-salpingectomy or -salpingotomy reproductive outcomes in women with tubal EPs.

STUDY

DESIGN

Medical history data of 95 patients diagnosed with tubal EP between January 2013 and December 2014 were analyzed in a retrospective, observational manner. All patients studied were offered two surgical management options: salpingectomy (removal of the entire fallopian tube), or salpingotomy (removal of products of gestation only, leaving the remainder of the tube intact). All 95 cases included in the study desired to preserve future fertility, and were followed up for 36 months after surgery. Follow-up data included evaluation for crude intrauterine pregnancy (IUP), recurrent EP and infertility.

RESULTS

Patients that underwent salpingectomy were noted to be significantly older than those that underwent salpingotomy (P < 0.05). In addition, childbearing rates were noted to be significantly higher in the salpingectomy group when compared to patients that underwent salpingotomy (P < 0.05). No significant differences were noted in mean dimension of mass, pregnancy rates, cesarean section rates and previous abortion rates between the two groups. We did not find a significant difference in fertility outcomes between the two groups.

CONCLUSIONS

Surgical management options for EP should be comprehensively evaluated in the clinical setting as numerous factors influence the decision making process. This paper provides a foundation for further studies upon which reliable surgical treatment guidelines for patients with tubal EP can be established.