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Ectopisk tubar graviditet

Ectopisk tubar graviditet. Fertilitet ved salpingektomi vs. t ubotomi Af Anne Lene Bülow-Lehnsby, Geske Bak og Mads Nielsen-Breining. Klinisk problemstilling. Hvad er den bedste operative behandling af patienter med ectopisk tubar graviditet i forhold til fremtidig fertilitet?

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Ectopisk tubar graviditet

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  1. Ectopisk tubar graviditet Fertilitet ved salpingektomi vs. tubotomi Af Anne Lene Bülow-Lehnsby, Geske Bak og Mads Nielsen-Breining

  2. Klinisk problemstilling Hvad er den bedste operative behandling af patienter med ectopisk tubar graviditet i forhold til fremtidig fertilitet? Eksklusiv: Laparotomi, ekspekterende behandling, methotraxat, persisterende trofoblastvæv.

  3. PICO • P Ekstrauterin tubar graviditet med operationsindikation • I Laparoskopisk salpingektomi • C Laparoskopisk tubotomi • O Fertilitetsoutcome

  4. Søgeord • (salpingotomy OR salpingostomy OR tubotomy) AND salpingectomy AND ectopic pregnancy MesH AND fertility

  5. Søgeresultater • Ectopic pregnancy MesH 11.487 • Salpingectomy 5.198 145 • Salpingotomy OR salpingostomy 705 • Limits: % editorial og letters 33 • Fertility 8.395 • AND AND AND 16

  6. State of the art • The ESEP study: salpingostomy versus salpingectomy for tubal ectopic pregnancy; the impact on future fertility: a randomised controlled trial. Mol F et al (European Surgery in Ectopic Pregnancy Study Group)

  7. Cochrane 2007: Hajenius PJ et al. Interventions for Tubal Ectopic Pregnancy • Review 2008: Mol F et al. Current evidence on surgery, systemic methotraxat and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis. • RCOG Guideline 2004

  8. 2 cohortestudier • Bangsgaard N et al. The cumulative intrauterine pregnancy rate was significantly higher after tubotomy (88%) than after salpingectomy (66%) (log rank P < 0.05). No difference was found in the recurrence rate of ectopic pregnancy between the treatments (16% vs 17%). • Silva PD et al. The overall intrauterine pregnancy rates for laparoscopic salpingostomy (60%) and laparoscopic salpingectomy (54%) were not significantly different from each other. However, intrauterine pregnancy rates differed significantly by history of prior tubal damage. The pregnancy rate was 79% among women without tubal damage and 42% among women with damage

  9. Klinisk anbefaling Vi anbefaler at der foretages tubotomi ved ønske om senere graviditet Evidensgrad IIb Styrke B

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