Particularities of endovideosurgical treatment of fallopian pregnancy

V. V. Strizheletskiy; Стрижелецкий В. В.; Е. I. Kakhiani; Кахиани Е. И.; Т. Y. Zhemchyuzhina; Жемчужина Т. Ю.; А. N. Tayts; Тайц А. Н.

doi:10.17816/JOWD87214

Particularities of endovideosurgical treatment of fallopian pregnancy

Authors: Strizheletskiy V.V.¹, Kakhiani Е.I.¹, Zhemchyuzhina Т.Y.¹, Tayts А.N.¹
Affiliations:
1. Saint Elizabeth Hospital
Issue: Vol 54, No 5S (2005)
Pages: 31-32
Section: Reviews
Submitted: 15.11.2005
Accepted: 06.11.2021
Published: 15.11.2005
URL: https://journals.eco-vector.com/jowd/article/view/87214
DOI: https://doi.org/10.17816/JOWD87214
ID: 87214

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feature of endovideosurgical treatment of tubal pregnancy, tubal pregnancy, tubal pregnancy treatment

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Actuality: optimization of operative methods is one of trends of the modem surgery. This trend is continued by endovideosurgery, the new technology, which provides not only diagnostics, but also treatment of gynecological diseases. This matter becomes especially urgent in emergency gynecological cases, such as fallopian pregnancy. In last 20 years its frequency became 3.7 times higher; 40% of women after surgical treatment of fallopian pregnancy suffers from secondary sterility, 20% - from habitual abortion and 15% - from repeated fallopian pregnancy.

Objectives of study. Estimation of advantages of endovideosurgical treatment of women with fallopian pregnancy.

Materials and methods. The present study is based upon 212 clinical observations of patients, which emergency underwent laparoscopic operation of fallopian pregnancy in St. Elisabeth Hospital.

The operation of choice was tubectomy using bipolar coagulation of mesosalpinx or with endoligation, or linear tubotomy with thorough aquadistillation of ovum bed (providing that the latter was not more than 25 mm in diameter) and subsequent control of blood level of HCG. The operation is completed by abdominal cavity sanation with antiseptic solutions, intraabdominal injection of 125 mg of hydrocortisone in 400 ml of physiological solution and diary dose of cephalosporins (in case of comissures in small pelvis) and control drainage of small pelvis.

Results of study. Among the observed patients 25 (12,3%) were women between 16 and 20 y/o, 55 (26,4%) - from 21 to 25 y/o, 79 (34,9%) - from 26 to 30 y/o, 29 (14,1%) - from 31 to 35 y/o, 15 (7,5%)

from 36 to 40 y/o and 9 (4,7%) - from 41 to 46 y/o. 96 (45,3%) patients had no previous deliveries, but 83 (87%) of them had one or more abortions, 100 (47,1%)
one previous delivery and 16 (7,5%) - two previous deliveries. Therefore, 75% of women operated on fallopian pregnancy were under 30 y/o and 45,3% had no previous deliveries. 10 (4,7%) patients suffered fallopian pregnancy after extracorporeal fertilization, 15 (7%) - after artificial insemination and 27 (12,7%)
after microsurgical operations on fallopian tubes. Tubectomy was performed in 193 (91%) patients, linear tubotomy - in 19 (9%) patients. 26 (13,7%) patients were undergone salpingostomy in contralateral tube or on pregnant one. Besides, 65 (31%) patients were undergone the releasing of tubes from comissures with ovaries, uterus or intestinal loops (salpingolysis). Total blood loss in each case did not exceed 500 ml. Changes of ovaries, varication in small pelvis and small forms of endometriosis found in process of endoscopic examination were taken into account for further conservative therapy aimed at recovery of reproductive function. The average bed-day was 4.0.

Resume. If we take into account the age and reproductive system condition of patients who usually require treatment of tubal pregnancy, such well-known advantages of laparoscopic surgery as microinvasiveness, short postoperative rehabilitation period and excellen.