Laparoscopy versus Laparotomy in the Surgical Management of Ectopic Pregnancy: Integrative Literature Review

Abstract

Background: Ectopic pregnancy (EP) is a common gynecological emergency in resource-limited countries, where laparotomy is the conventional therapy despite the fact that laparoscopic surgery is considered the best option. There is a lack of prospective randomized evidence comparing laparoscopic surgery with laparotomy in the surgical care of women with REP. Objectives: To summarize current evidences comparing laparoscopy versus laparotomy in the surgical management of ectopic pregnancy. Methodology: PubMed, Web of Science, Science Direct, EBSCO, and Cochrane Library were utilized to identify the articles. In the current review, all pertinent articles related to both our topic and other articles were used. Other articles not related to the objective of the review were excluded. The research team looked through a standardized format in which the data had been extracted. Results: According to PRSIMA guidelines, our study included 13 published studies that were registered to extract final data from a total of 110 studies found after searching the mentioned databases, which were then used for title screening. Some were excluded from screening of abstracts and others due to different inclusion criteria, after full-text review. These 13 studies were used to compare laparoscopy versus laparotomy in the surgical management of EP, establishing that laparoscopic treatment of EP may be the most beneficial method with the highest level of safety and efficacy. Conclusion: Laparoscopic surgery is increasingly being used as the method of choice for treating EPs. When compared to laparotomy, laparoscopic treatment for EP raises concerns about safety, viability and results in fewer postoperative adhesions. Laparoscopy is also more practicable and proven to be more efficient in terms of blood loss, requirement for blood transfusion, need for analgesia, and time of postoperative hospital stay.