Laparoscopic salpingectomy in tubal pregnancy: Prospective randomized trial using endoloop versus electrocautery

Yun Hsuen Lim, Soon P. Ng, Paul H O Ng, Ay E. Tan, Muhammad A. Jamil

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Aim: Ectopic pregnancy is conventionally managed by laparoscopic salpingectomy. Electrocautery has been used widely to secure hemostasis during salpingectomy. However, this method is associated with a risk of thermal injury to the visceral organs. Endoloop, a pre-tied suture used in laparoscopic surgery may be an alternative treatment tool and its potential use in the management of ectopic pregnancy is explored here. Our study aims to compare the effectiveness of the endoloop technique to electrocautery during laparoscopic salpingectomy for tubal pregnancy. Methods: A prospective randomized controlled study was conducted over 24 months at the Hospital Universiti Kebangsaan Malaysia. One hundred and two patients with tubal pregnancy were randomized into two treatment groups: those treated with endoloop and those treated with electrocautery during laparoscopic salpingectomy. Results: The use of an endoloop was associated with a shorter operating time (48.85 min ± 21.019 vs 61.14 min ± 22.603, 95% CI -20.864 to -3.724), lower visual analog scores for postoperative pain at day 1 (2.02 ± 0.960 vs 2.74 ± 0.828, 95% CI -1.074 to -0.368) and day 7 (0.85 ± 0.802 vs 1.44 ± 0.837, 95% CI -0.916 to -0.272), and lesser total analgesia required by patients at day 7 after the operation (7.65 ± 6.119 vs 15.32 ± 8.326, 95% CI -10.529 to -4.804). There was no significant difference in the ability to secure hemostasis when both techniques were compared. Duration of hospitalization (2.37 days ± 0.817 vs 2.34 days ± 0.519, 95% CI -0.245 to -0.296) and interval from operation to discharge were similar. Conclusion: The endoloop appeared to be as effective as electrocautery and is a safe alternative to electrocautery for laparoscopic salpingectomy in tubal pregnancy.

    Original languageEnglish
    Pages (from-to)855-862
    Number of pages8
    JournalJournal of Obstetrics and Gynaecology Research
    Volume33
    Issue number6
    DOIs
    Publication statusPublished - Dec 2007

    Fingerprint

    Salpingectomy
    Tubal Pregnancy
    Electrocoagulation
    Ectopic Pregnancy
    Hemostasis
    Malaysia
    Postoperative Pain
    Laparoscopy
    Analgesia
    Sutures
    Hospitalization
    Hot Temperature
    Wounds and Injuries
    Therapeutics

    Keywords

    • Ectopic pregnancy
    • Electrocautery
    • Endoloop
    • Laparoscopic salpingectomy
    • Tubal pregnancy

    ASJC Scopus subject areas

    • Obstetrics and Gynaecology

    Cite this

    Laparoscopic salpingectomy in tubal pregnancy : Prospective randomized trial using endoloop versus electrocautery. / Lim, Yun Hsuen; Ng, Soon P.; Ng, Paul H O; Tan, Ay E.; Jamil, Muhammad A.

    In: Journal of Obstetrics and Gynaecology Research, Vol. 33, No. 6, 12.2007, p. 855-862.

    Research output: Contribution to journalArticle

    Lim, Yun Hsuen ; Ng, Soon P. ; Ng, Paul H O ; Tan, Ay E. ; Jamil, Muhammad A. / Laparoscopic salpingectomy in tubal pregnancy : Prospective randomized trial using endoloop versus electrocautery. In: Journal of Obstetrics and Gynaecology Research. 2007 ; Vol. 33, No. 6. pp. 855-862.
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    abstract = "Aim: Ectopic pregnancy is conventionally managed by laparoscopic salpingectomy. Electrocautery has been used widely to secure hemostasis during salpingectomy. However, this method is associated with a risk of thermal injury to the visceral organs. Endoloop, a pre-tied suture used in laparoscopic surgery may be an alternative treatment tool and its potential use in the management of ectopic pregnancy is explored here. Our study aims to compare the effectiveness of the endoloop technique to electrocautery during laparoscopic salpingectomy for tubal pregnancy. Methods: A prospective randomized controlled study was conducted over 24 months at the Hospital Universiti Kebangsaan Malaysia. One hundred and two patients with tubal pregnancy were randomized into two treatment groups: those treated with endoloop and those treated with electrocautery during laparoscopic salpingectomy. Results: The use of an endoloop was associated with a shorter operating time (48.85 min ± 21.019 vs 61.14 min ± 22.603, 95{\%} CI -20.864 to -3.724), lower visual analog scores for postoperative pain at day 1 (2.02 ± 0.960 vs 2.74 ± 0.828, 95{\%} CI -1.074 to -0.368) and day 7 (0.85 ± 0.802 vs 1.44 ± 0.837, 95{\%} CI -0.916 to -0.272), and lesser total analgesia required by patients at day 7 after the operation (7.65 ± 6.119 vs 15.32 ± 8.326, 95{\%} CI -10.529 to -4.804). There was no significant difference in the ability to secure hemostasis when both techniques were compared. Duration of hospitalization (2.37 days ± 0.817 vs 2.34 days ± 0.519, 95{\%} CI -0.245 to -0.296) and interval from operation to discharge were similar. Conclusion: The endoloop appeared to be as effective as electrocautery and is a safe alternative to electrocautery for laparoscopic salpingectomy in tubal pregnancy.",
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    AU - Ng, Paul H O

    AU - Tan, Ay E.

    AU - Jamil, Muhammad A.

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    N2 - Aim: Ectopic pregnancy is conventionally managed by laparoscopic salpingectomy. Electrocautery has been used widely to secure hemostasis during salpingectomy. However, this method is associated with a risk of thermal injury to the visceral organs. Endoloop, a pre-tied suture used in laparoscopic surgery may be an alternative treatment tool and its potential use in the management of ectopic pregnancy is explored here. Our study aims to compare the effectiveness of the endoloop technique to electrocautery during laparoscopic salpingectomy for tubal pregnancy. Methods: A prospective randomized controlled study was conducted over 24 months at the Hospital Universiti Kebangsaan Malaysia. One hundred and two patients with tubal pregnancy were randomized into two treatment groups: those treated with endoloop and those treated with electrocautery during laparoscopic salpingectomy. Results: The use of an endoloop was associated with a shorter operating time (48.85 min ± 21.019 vs 61.14 min ± 22.603, 95% CI -20.864 to -3.724), lower visual analog scores for postoperative pain at day 1 (2.02 ± 0.960 vs 2.74 ± 0.828, 95% CI -1.074 to -0.368) and day 7 (0.85 ± 0.802 vs 1.44 ± 0.837, 95% CI -0.916 to -0.272), and lesser total analgesia required by patients at day 7 after the operation (7.65 ± 6.119 vs 15.32 ± 8.326, 95% CI -10.529 to -4.804). There was no significant difference in the ability to secure hemostasis when both techniques were compared. Duration of hospitalization (2.37 days ± 0.817 vs 2.34 days ± 0.519, 95% CI -0.245 to -0.296) and interval from operation to discharge were similar. Conclusion: The endoloop appeared to be as effective as electrocautery and is a safe alternative to electrocautery for laparoscopic salpingectomy in tubal pregnancy.

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