Laparoscopic treatment of XXXX : a series of 20 consecutive cases.

@entity1 @entity3556 @entity1457 @entity177 @entity8040 @entity1500 @entity490 @entity1499 @entity4338
OBJECTIVE: To determine the outcome of laparoscopic management of @entity8040 . DESIGN: Retrospective cohort study (Canadian Task Force classification II-3). SETTING: A tertiary referral hospital in Israel. @entity1 (S): Twenty-seven consecutive @entity1 with @entity8040 who were diagnosed and treated at our institute. INTERVENTION(S): Laparoscopy was undertaken in 20 (74%) of the @entity1 . Resection of the cornua and/or a Vicryl loop placement was performed. In 6 cases, laparoscopy was converted to laparotomy. In addition, laparotomy was performed in 2 other cases. Five cases were managed conservatively: 3 with systemic @entity1499 ( @entity1500 ) and leucovorin, 1 with transvaginal sonography-guided KCl injection to the amniotic sac, and 1 with hysteroscopic-guided @entity1500 injection to the amniotic sac. Further treatment after surgery was required in 4 cases: transvaginal sonography-guided KCl injection, @entity1500 or @entity4338 + @entity1500 (1 case each) injection to the amniotic sac, and systemic @entity1500 injection. MAIN OUTCOME MEASURE(S): Successful laparoscopy, determined as not needing follow-up treatment. RESULT(S): The mean gestational age was 56 days. The average and median serum hCG levels were 31,199 and 6,653 IU/mL, respectively. Six of the @entity1 (22%) were admitted in @entity1457 . Nine @entity1 (33.3%) were asymptomatic upon admission, 14 (52%) had @entity490 , and 8 (29.6%) were evaluated for @entity3556 . One @entity1 developed @entity1457 after admission. Only 15 (55.6%) of the 27 pregnancies were diagnosed as a @entity8040 by transvaginal sonography before the therapeutic procedure. Blood transfusion was given in seven cases (26%) during surgery. The mean number of days of hospitalization was 5.7 days for @entity1 who underwent surgery and was 7.1 days for all @entity1 . A comparison was made between the first 11 and the last 11 cases treated surgically. Although the two groups were similar in all parameters, conversion from laparoscopy to laparotomy was higher in the first group, although not at a statistically significant level. CONCLUSION(S): Improved laparoscopic technique, accumulated experience, and possibly earlier diagnosis have led to fewer @entity177 or need to convert to laparotomy during treatment of @entity8040 . Conservative treatment, when possible, should be considered. If surgery is indicated, and as more laparoscopic skill is gained, laparoscopy should be considered the preferred method of treating @entity8040 . In experienced hands, laparoscopy is a safe and effective treatment for @entity8040 .
