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 |