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Table 7 Studies on surgical management of IPs

From: The diagnosis and management of interstitial ectopic pregnancies: a review

Paper Location Mode of surgical management (cases) No. of cases Patient age (years) Gestation (weeks) Diameter of GS (mm) Foetal cardiac activity (FCA) present β-hCG (IU/ml) Comments
Moon et al. 2000 [41] Moon Hwa Hospital, Pusan
(South Korea)
[1993–1998]
Retrospective case series
Laparoscopic cornuostomy (24)
Endo-loop vs. vasopressin + electric cauterization vs. encircling suture
24 33.4 +/− 5.8 7.6 35.29 7 2652.8 95.8% success rate
75% pregnancy rate in future
No ipsilateral ectopics
Tulandi et al. 2004 [7] Multi-centre
(Europe, North America, Chile)
[1999–2002]
Retrospective case series
Laparoscopic: cornual resection (8) vs. cornuostomy (3) 11 32.6 +/− 1.0 5.4 +/− 1.0 11 +/− 6 2086.9 +/− 698.2 90.9% success rate
1 failed primary treatment (9.1%)
Subsequent treatment: single dose/multi-dose MTX (for persistently elevated β-hCG)
Tulandi et al. 2004 [7] Multi-centre
(Europe, North America, Chile)
[1999–2002]
Retrospective case series
Laparotomic cornual resection 13   7.3 +/− 0.4 14 +/− 8   11,471 +/− 6281 100% success rate
9 cases had tubal rupture confirmed
Choi et al. 2009 [50] EUN Hospital (South Korea)
[? Years]
Retrospective case series
Laparoscopic cornuostomy (8) 8 7.6 +/− 1.11 33 +/− 6.7 5 3656 +/− 2573 100% success rate
Operating time 50 +/− 22 min
No major post-operative complications
β-hCG normalised by 26.5 +/− 7 days
Moon et al. 2010 [37] Moon Hwa Hospital, Pusan
(South Korea)
[2003–2006]
Retrospective case series
Laparoscopic cornuostomy (20) 20 33.5 +/− 3.2 6.7 +/− 1.2   1095 (? range) 100% success rate
Time to resumption of menstrual period: 38.6 days
Hwang et al. 2011 [42] Korea University Medical Center
(South Korea)
[1998–2009]
Case – control study
Open cornual resection (49) vs. laparoscopic cornual resection (39) 88 32.5 (19–42) 7.86 +/− 1.7   22 (22.5%) 12,741 +/− 103–81,351) 5 cases of laparoscopic management needed conversion to open management.
No statistical differences in operating time, estimated blood loss, blood transfusion requirements, or complications
Mean post-operative inpatients admission was 5.89 +/− 1.86 days (laparotomy) vs. 4.53 +/− 1.44 days (laparosocopy) (P = 0.0001)
Poon et al. 2014 [18] King’s College Hospital (London, UK)
[2004–2013]
Retrospective case series
  9   8.21 (5.1–11) 31.5 (13–44) 3 (33%) 9,402 (2225–75,530) No comments
Hiersch et al. 2014 [11] The Helen Schneider Hospital for Women (Israel)
[2003–2013]
Retrospective case series
  7 32 +/− 5.8 10.5 +/− 5.5 2094.8 +/− 1721.3 No comments
Watanabe et al. 2014 [38] NTT East Japan Tohoku Hospital and Sendai City Hospital (Japan)
[2000–2012]
Retrospective case series
Laparoscopic cornuostomy + MTX administration to local site (13) 13   7.6 +/− 1.3 weeks (5–9) 34.6 +/− 10.2 3 20,800 +/− 18,100 100% success rate
Mean operative time 107 +/− 23 min (61–160)
Mean haemoglobin drop was from 12.4 +/− 1.0 to 10.3 +/− 1.7 g/dL
No major post-operative complications
No persistent ectopic pregnancies
10/13 patients followed up
8 conceived spontaneously [average 13 months after the procedure]:
1 pregnancy ended in early miscarriage;
3 delivered by ventouse delivery, the other? 2 by elective caesarean section
Liao et al. 2016 [32] Mennonite Christian Hospital
(? country)
[1992–2013]
Retrospective case series
Laparoscopic cornual resection (29) 29 31 (18–43) 8 (5–12 + 1)     Of the 10 pregnancies post-cornual resection, there were 3 cases of subsequent uterine rupture or dehiscence (30%)
71.4% of patients who were trying to conceive achieved subsequent pregnancy
No recurrent ectopic pregnancies
Nirgianakis et al. 2017 [43] University of Bern
(Switzerland)
[2009–2015]
Retrospective case series
Laparoscopic cornual resection (10) 10 34.50 +/− 6.21 53.25 +/− 16.79 days    27,634 +/− 35,198 100% success rate
EBL 137.00 +/− 178.64 mL
3 patients required blood transfusions
Length of hospitalisation was 2.67 +/− 1.00 days