A systematic review and meta-analysis of laparotomy compared with laparoscopic management of interstitial pregnancy.
Interstitial pregnancy
cornual
ectopic
laparoscopy
laparotomy
meta-analysis
Journal
Facts, views & vision in ObGyn
ISSN: 2032-0418
Titre abrégé: Facts Views Vis Obgyn
Pays: Belgium
ID NLM: 101578773
Informations de publication
Date de publication:
08 Jan 2021
08 Jan 2021
Historique:
entrez:
12
2
2021
pubmed:
13
2
2021
medline:
13
2
2021
Statut:
epublish
Résumé
Interstitial pregnancy is a rare but life-threatening condition accounting for 1-4% of all types of tubal ectopic pregnancies. It can be managed by open and minimally invasive surgical techniques. Our goal was to compare laparoscopic and open surgery for managing interstitial pregnancy. We searched PubMed, Scopus, Web of Science, and Cochrane up to May 2020. 1) Women with interstitial pregnancy, 2) Intervention: laparoscopic surgery, 3) Comparator: open surgery, 4) Outcomes: Hospital stay, operation time, pain scale, blood loss. Secondary outcomes: any other reported 5) Study designs: interventional and observational. Data was extracted from the relevant articles and was pooled as mean difference (MD) or relative risk (RR) with a 95% confidence interval (CI). We included six studies, three of which provided eligible data. The duration of hospital stay was lower in the laparoscopic surgery group (MD = -1.42, 95% CI [-1.72, -0.76], P < 0.0001). There was no significant difference in operative time (MD = 5.90, 95% CI [-11.30, 23.09], P = 0.50, blood loss (MD = -9.43, 95% CI [-214.18, 195.32], P = 0.93), complications (RR = 1.54, 95% CI [0.20, 11.85], P = 0.68), or blood transfusions (RR = 0.77, 95% CI [0.50, 1.25], P = 0.30). Laparoscopic surgery is associated with shorter hospital stay, with no difference in terms of blood loss, post-, and intraoperative complications, and need for blood transfusion compared with laparotomy.
Sections du résumé
BACKGROUND
BACKGROUND
Interstitial pregnancy is a rare but life-threatening condition accounting for 1-4% of all types of tubal ectopic pregnancies. It can be managed by open and minimally invasive surgical techniques. Our goal was to compare laparoscopic and open surgery for managing interstitial pregnancy.
SEARCH STRATEGY
METHODS
We searched PubMed, Scopus, Web of Science, and Cochrane up to May 2020.
SELECTION CRITERIA
METHODS
1) Women with interstitial pregnancy, 2) Intervention: laparoscopic surgery, 3) Comparator: open surgery, 4) Outcomes: Hospital stay, operation time, pain scale, blood loss. Secondary outcomes: any other reported 5) Study designs: interventional and observational.
DATA COLLECTION AND ANALYSIS
METHODS
Data was extracted from the relevant articles and was pooled as mean difference (MD) or relative risk (RR) with a 95% confidence interval (CI).
MAIN RESULTS
RESULTS
We included six studies, three of which provided eligible data. The duration of hospital stay was lower in the laparoscopic surgery group (MD = -1.42, 95% CI [-1.72, -0.76], P < 0.0001). There was no significant difference in operative time (MD = 5.90, 95% CI [-11.30, 23.09], P = 0.50, blood loss (MD = -9.43, 95% CI [-214.18, 195.32], P = 0.93), complications (RR = 1.54, 95% CI [0.20, 11.85], P = 0.68), or blood transfusions (RR = 0.77, 95% CI [0.50, 1.25], P = 0.30).
CONCLUSION
CONCLUSIONS
Laparoscopic surgery is associated with shorter hospital stay, with no difference in terms of blood loss, post-, and intraoperative complications, and need for blood transfusion compared with laparotomy.
Types de publication
Systematic Review
Langues
eng
Pagination
299-308Informations de copyright
Copyright © 2020 Facts, Views & Vision.
Déclaration de conflit d'intérêts
Conflicts of Interest:Authors declare no conflicts of interest.
Références
Obstet Gynecol. 2004 Jan;103(1):47-50
pubmed: 14704243
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Hum Reprod. 1999 May;14(5):1401-3
pubmed: 10325302
Am J Obstet Gynecol. 2000 May;182(5):1264-70
pubmed: 10819869
J Minim Invasive Gynecol. 2017 Mar - Apr;24(3):397-401
pubmed: 27956106
J Am Assoc Gynecol Laparosc. 2001 Feb;8(1):154-8
pubmed: 11172133
J Am Assoc Gynecol Laparosc. 2000 Aug;7(3):387-9
pubmed: 10924634
Lancet. 1995 May 6;345(8958):1139-43
pubmed: 7723545
J Am Assoc Gynecol Laparosc. 1995 Aug;2(4):471-3
pubmed: 9050605
Fertil Steril. 2008 Sep;90(3):839-43
pubmed: 17936282
J Reprod Med. 2003 Jul;48(7):569-71
pubmed: 12953336
Eur J Emerg Med. 2001 Jun;8(2):147-50
pubmed: 11436912
Gynecol Obstet Invest. 2014;78(3):141-9
pubmed: 25060047
BJOG. 2016 Dec;123(13):e15-e55
pubmed: 27813249
Fertil Steril. 1999 Aug;72(2):207-15
pubmed: 10438980
Fertil Steril. 2006 Dec;86(6):1764.e11-4
pubmed: 17094984
Obstet Gynecol. 1995 Mar;85(3):465-7
pubmed: 7862394
Fertil Steril. 2009 Aug;92(2):448-52
pubmed: 18930204
Gynecol Obstet Invest. 2018;83(4):329-337
pubmed: 29669329
Clin Obstet Gynecol. 2009 Sep;52(3):372-9
pubmed: 19661753
Acta Obstet Gynecol Scand. 2013 Nov;92(11):1327-30
pubmed: 23962257
BMJ. 1997 Sep 13;315(7109):629-34
pubmed: 9310563
JSLS. 2014 Apr-Jun;18(2):197-203
pubmed: 24960482
Am J Obstet Gynecol. 2010 Jan;202(1):15-29
pubmed: 20096253
Eur J Obstet Gynecol Reprod Biol. 2011 May;156(1):78-82
pubmed: 21236556
Gynecol Minim Invasive Ther. 2018 Jan-Mar;7(1):22-26
pubmed: 30254930
BMC Pregnancy Childbirth. 2018 Mar 27;18(1):78
pubmed: 29587664