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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