International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2013
Laparoscopy versus laparotomy in the management of ectopic pregnancy with massive hemoperitoneum.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cohen Aviad, Almog Benny, Satel Abed, Lessing Joseph B, Tsafrir Ziv, Levin Ishai
Аннотация
OBJECTIVE: To compare the safety and feasibility of operative laparoscopy versus laparotomy in women with ruptured ectopic pregnancy and massive hemoperitoneum.
METHODS: In a retrospective cohort study at a university-affiliated medical center, records of women with ruptured ectopic pregnancy and massive hemoperitoneum (>800mL) were reviewed.
RESULTS: Sixty women were diagnosed with ruptured ectopic pregnancy and massive hemoperitoneum: 48 underwent emergency laparoscopy; 12 underwent emergency laparotomy. There was no difference in hemodynamic status at presentation between the groups. Median operating time was significantly shorter in the laparoscopy group (50minutes [range, 43-63minutes] vs 60minutes [range, 60-72minutes]; P=0.01). Median intra-abdominal blood loss was significantly greater in the laparotomy group (1500mL [range, 1400-2000mL] vs 1000mL [range, 800-1200mL]; P=0.002). There was no difference between the groups regarding treatment with blood products, perioperative complications, and hospitalization period.
CONCLUSION: In patients with ruptured ectopic pregnancy and massive hemoperitoneum, laparoscopy is feasible and safe, with significantly shorter operating times compared with laparotomy. While the mode of surgery should be based on the surgeon's experience and preference, the significantly lower hemoperitoneum volume associated with laparoscopy may be a reflection of shorter operating times and quicker hemorrhage control.
METHODS: In a retrospective cohort study at a university-affiliated medical center, records of women with ruptured ectopic pregnancy and massive hemoperitoneum (>800mL) were reviewed.
RESULTS: Sixty women were diagnosed with ruptured ectopic pregnancy and massive hemoperitoneum: 48 underwent emergency laparoscopy; 12 underwent emergency laparotomy. There was no difference in hemodynamic status at presentation between the groups. Median operating time was significantly shorter in the laparoscopy group (50minutes [range, 43-63minutes] vs 60minutes [range, 60-72minutes]; P=0.01). Median intra-abdominal blood loss was significantly greater in the laparotomy group (1500mL [range, 1400-2000mL] vs 1000mL [range, 800-1200mL]; P=0.002). There was no difference between the groups regarding treatment with blood products, perioperative complications, and hospitalization period.
CONCLUSION: In patients with ruptured ectopic pregnancy and massive hemoperitoneum, laparoscopy is feasible and safe, with significantly shorter operating times compared with laparotomy. While the mode of surgery should be based on the surgeon's experience and preference, the significantly lower hemoperitoneum volume associated with laparoscopy may be a reflection of shorter operating times and quicker hemorrhage control.