Tubal ectopic pregnancy: An evaluation of laparoscopic surgery versus laparotomy in 614 patients

We performed a prospective nonrandomized multicentre study to compare lapar oscopic surgery and laparotomy in the immediate surgical outcome of tubal e ctopic pregnancy (TEP), at 9 teaching hospitals in Hong Kong with a laparos copic surgical service, on all patients with the operative diagnosis of tub al ectopic pregnancy between July 1, 1996 and June 30, 1997. In the period studied, 630 patients were recruited of which 614 were suitable for analysi s. In them, 382 (62.2%) had laparoscopic surgery while the rest had laparot omy with or without diagnostic laparoscopy. Significantly more cases of sho ck ended in laparotomy (86.1% versus 13.9%). After exclusion of patients wi th shock, laparoscopic surgery offered a significantly shorter postoperativ e hospital stay (mean 2.7 days versus 5.3 days), a slightly lower periopera tive complication rate (8.1% versus 13.9%) and more conservative surgery (9 0.1% of all salpingotomies) than laparotomy. A longer operating time was ne eded for laparoscopic surgery (1.2 hours versus 1.01 hours).