| 419 the retroperitoneum via lymphatic channels or via an obstetric fistula between the uterus and retroperitoneum that may occur following a salpingectomy. 3 At present, there are no guidelines for REP management. In the present study, laparotomy was performed for the treatment of REP. REP tends to be located close to large blood vessels. Therefore, laparoscopic management is not applied routinely due to the risk of massive and uncontrollable hemorrhage. In any approach, it should be noted that a multidisciplinary, highly skilled team composed of a gynecologist and an abdominal surgeon must be convened. Systematic methotrexate could be used postoperatively. However, in cases where the removal of the trophoblastic tissue appears complete, this adjuvant treatment may not be necessary.
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