A new tubal classification system for fertility prognosis after laparoscopic salpingostomy for tubal pregnancy

Ding, Yan; Huang, Wen; Jiang, Hongyuan; Jin, Zhu

doi:10.1016/j.ejogrb.2016.03.036

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…With the progress of medical technology, especially hysteroscopy and laparoscopy, a minimally invasive operation has greatly increased the recanalization rate of blocked fallopian tubes. However, the pregnancy rate is still low and has a strong possibility of ectopic pregnancy [ 33 , 34 ]. Therefore, we need an auxiliary treatment aimed at improving the efficacy, reducing side effects and improving the prognosis.…”

Section: Discussionmentioning

confidence: 99%

Evidence-based complementary and alternative medicine conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility: A systematic review and meta-analysis

Jin²,

Yang³

et al. 2023

PLoS ONE

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Background Chinese medicinal retention enemas have gradually attracted the attention of clinicians as an alternative approach for tubal obstructive infertility. The purpose of this study was to investigate the efficacy and safety of conventional surgery combined with traditional Chinese medicinal retention enemas for the treatment of tubal obstructive infertility. Materials and methods Eight electronic databases were searched from their inception to November 30, 2022. To assess the efficacy and safety of different treatments, following outcomes were measured: clinical pregnancy rate, clinical total effective rate, incidence of ectopic pregnancy, the improvement of Traditional Chinese Medicinal (TCM) symptoms, the improvement of the signs of obstructive tubal infertility and side effects. Results A total of 23 Randomized Controlled Trials (RCTs) with 1909 patients met the inclusion criteria. The pooled results showed a higher pregnancy rate in the experimental group than in the control group (RR 1.75, 95% CI [1.58, 1.94], Z = 10.55, P<0.00001). The clinical total effective rate in the experimental group was higher than that in the control group (RR 1.28, 95% CI [1.23, 1.34], Z = 11.07, P<0.00001). The incidence of ectopic pregnancy in the experimental group was lower than that in the control group (RR 0.40, 95% CI [0.20, 0.77], Z = -2.73, P = 0.01). Conclusion Based on current evidence, we concluded that conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility was superior to conventional surgery alone in improving the clinical pregnancy rate, improving clinical total effective rate, improving TCM symptoms, improving the signs of obstructive tubal infertility and lowering the incidence of ectopic pregnancy. However, further clinical trials with high-quality methodologies need to be conducted.

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Section: Discussionmentioning

confidence: 99%

Evidence-based complementary and alternative medicine conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility: A systematic review and meta-analysis

Jin²,

Yang³

et al. 2023

PLoS ONE

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“…Ding et al found no difference in the rate of intrauterine pregnancy before and after salpingostomy or salpingectomy. However, the rate of recurrent ectopic pregnancy was slightly higher after salpingostomy, particularly if the affected tube was diseased [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the recurrence and fertility rate following salpingostomy in patients with tubal ectopic pregnancy

Poordast

Naghmehsanj

Vahdani

et al. 2022

BMC Pregnancy Childbirth

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Background Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy. Methods This cross-sectional retrospective study was conducted at four referral centers of Obstetrics and Gynecology, under the supervision of Shiraz University of Medical Sciences (Iran). The medical records of 125 patients with tubal pregnancy were reviewed. These patients underwent laparoscopic salpingostomy from April 2009 to March 2016.Data on maternal age, BMI, history of previous EP, genital tract infection, IUD insertion, history of previous surgery, and infertility were further obtained. The patients were followed up for approximately 1 to 7 years. The recurrence of EP and subsequent pregnancy rate were assessed during the follow-up period. Results There was no statistically significant relationship between post-salpingostomy recurrence and maternal age, previous abdominopelvic surgery, and history of infertility(P = .425); however, the post-salpingostomy recurrence of EP was correlated with BMI (P = 0.001), previous history of EP (P = 0.001), genital tract infection (P = 0.001), and IUD insertion (P = 003). Among 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and recurrence of EP was observed in 16 patients (12.8%). Conclusions Our results suggest that salpingostomy is a safe method with a low risk of recurrence and good fertility outcomes for women who consider future pregnancy.

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“…Total and partial salpingectomy might be selected in cases in which the patient does not want any further children, but salpingotomy might be chosen to preserve future natural fertility, especially in primiparous women. In a large retrospective study, salpingotomy was found to be significantly better at preserving fertility than total salpingectomy, although total salpingectomy carries a lower risk of recurrent ectopic pregnancy [2, 3, 11]. Although complete tubal resection cannot prevent cornual pregnancy, it might reduce the risk of recurrent ectopic pregnancy in the remnant tube.…”

Section: Discussionmentioning

confidence: 99%

A Third Surgically Managed Ectopic Pregnancy after Two Salpingectomies Involving the Opposite Tube

Iwahashi

Deguchi

Horiuchi

et al. 2017

Case Reports in Obstetrics and Gynecology

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Recurrent ectopic pregnancy in a remnant fallopian tube after ipsilateral salpingectomy is clinically rare. We report the extremely rare case of a third recurrent ectopic pregnancy after two previous salpingectomy procedures involving the opposite tube. A 26-year-old woman, gravida 3 para 0, experienced three ectopic pregnancies brought about by natural conception, all of which were treated surgically (right partial salpingectomy, right remnant tube resection, and left total salpingectomy). During the two salpingectomy procedures involving the right tube, the patency of the intact left tube was intraoperatively confirmed with indigo carmine. The most appropriate surgical intervention should be discussed when managing recurrent ectopic pregnancies. It might be necessary to perform total salpingectomy to reduce the risk of future recurrence on the remaining tube.

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A new tubal classification system for fertility prognosis after laparoscopic salpingostomy for tubal pregnancy

Cited by 5 publications

References 23 publications

Evidence-based complementary and alternative medicine conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility: A systematic review and meta-analysis

Evidence-based complementary and alternative medicine conventional surgery combined with traditional Chinese medicinal retention enema for tubal obstructive infertility: A systematic review and meta-analysis

Evaluation of the recurrence and fertility rate following salpingostomy in patients with tubal ectopic pregnancy

A Third Surgically Managed Ectopic Pregnancy after Two Salpingectomies Involving the Opposite Tube

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