Medicinski vjesnik, Vol. 27 No. (1-2), 1995.
Stručni rad
Approach in the treatment of tubal pregnancies
Tomislav Čanić
Srećko Ciglar
Vjekoslav Kašnar
Sažetak
In the period from February, 1992 to March, 1995 163 tubal pregnancies (TP) were treated at the University Clinic of Gynecology and Obstetrics of the Merkur Clinical Hospital in Zagreb. The methods and the results of treatment are presented in this paper. The total of 26.4% of TP’s were treated by laparoscopy, the method constantly increasing in use over the observed period - in 1995 a half of the patients were treated this way. The following laparoscopic methods were applied: (partial) salpingectomy, salpingotomy, “milking” of the tube and instillation of the 50% glucose solution. On the average, laparoscopically treated patients were 31 years old, amenorrhoic for 48 days, with haematoperitoneum of 19 ml and the ß HCG of 1650 mlE/ml (min. 77, max. 11,430). 10% of the patients had been previously treated for infertility, 28% were nulliparous, 56% had a history of artificial and 28% of spontaneous abortions. There were 13% of the patients with previous TP’s and 18.5% with PID, whereas 28% had a gynecological and 12.5% an abdominal surgery. IUD was used by 9.4 % of them. As many as 56% were admitted to the hospital as an emergency case, 8% in the state of shock. The average hospital stay was 3-7 days, the average operation duration 38.3 minutes, both significantly shorter than in cases treated by laparotomy. All cases treated conservatively by laparoscopy were unruptured TP’s located ampullary or isthmically, with the expressed wish for further reproduction. Three cases treated successfully with hypertonic glucose solution are presented. The proven advantages of laparoscopic treatment, such as shorter operation time, shorter hospital stay and minor trauma or the patient are confirmed in this study again. These, together with 100% efficiency make laparoscopy conditio sine qua non in modern treatment of tubal pregnancy.
Ključne riječi
Hrčak ID:
192961
URI
Datum izdavanja:
1.12.1995.
Posjeta: 778 *