2012, Number 12
<< Back Next >>
Ginecol Obstet Mex 2012; 80 (12)
Laparoscopic resection of an interstitial ectopic twin pregnancy resection: the role of barbed sutures in haemostatic control
Cardoso MB, Hernández GC, Manual CJ, Sarmiento P
Language: Spanish
References: 15
Page: 772-776
PDF size: 210.21 Kb.
ABSTRACT
Interstitial pregnancy is a dangerous and uncommon variation of
ectopic pregnancy occurring in the interstitial part of the fallopian
tube and extending beyond the muscular layer of the uterus. This
ectopic pregnancy-related mortality rate has been reported to be
as high as 2%-2,5% due to complications involving bleeding and
hypervascularity. No prospective clinical trials have evaluated available
treatment options for interstitial ectopic pregnancy due to its low
incidence; there is thus no consensus regarding optimal treatment.
Surgical treatment can be divided into conservative approaches,
such as cornuectomy or cornuostomy, and radical approaches
such as hysterectomy. However, intraoperative hemorrhage is an
ever-present risk, regardless of the surgical approach adopted.
This paper presents a case involving a patient who underwent
laparoscopic resection of an interstitial twin ectopic pregnancy; a
barbed suture pursestring was used which proved useful during the
surgical technique and improved hemostasia.
REFERENCES
Tulandi T, Al-Jaroudi D. Interstitial pregnancy: results generated from the Society of Reproductive Surgeons Registry. Obstet Gynecol 2004;103:47-50.
Ramírez Arreola L, Nieto Galicia LA, Escobar Valencia A, Cerón Saldaña MA. Cornual ectopic pregnancy. A report of a case and five-year-retrospective review. Ginecol Obstet Mex 2007;75(4):219-223.
Lau S, Tulandi T. Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril 1999;72:207- 215.
Pérez Salazar JL. Considerations on some aspects of ectopic pregnancy. Analysis of 50 cases operated. Ginecol Obstet Mex 2011;79(6):389-401.
Moawad NS, Mahajan ST, Moniz MH, Taylor SE, Hurd WW. Current diagnosis and treatment of interstitial pregnancy. Am J Obstet Gynecol 2010;202(1):15-29.
Cai Z, Wang F, Cao H, Xia Q, Chen X, Cai Y. The value of laparoscopy alone or combined with hysteroscopy in the treatment of interstitial pregnancy: analysis of 22 cases. Arch Gynecol Obstet 2012;285(3):727-32.
MacRae R, Olowu O, Rizzuto Ml, Odejinmi F. Diagnosis and laparoscopic management of 11 consecutive cases of cornual ectopic pregnancy. Arch Gynecol Obstet 2009;280(1):59-64.
Walid MS, Heaton RL. Diagnosis and laparoscopic treatment of cornual ectopic pregnancy. Ger Med Sci 2010 Jul 27;8.
Alessandri F, Remorgida V, Venturini PL, Ferrero S. Unidirectional barbed suture versus continuous suture with intracorporeal knots in laparoscopic myomectomy: a randomized study. J Minim Invasive Gynecol 2010;17(6):725-9.
Takeda A, Koyama K, Imoto S, Mori M, Sakai K, Nakamura H. Successful management of interstitial pregnancy with fetal cardiac activity by laparoscopic-assisted cornual resection with preoperative transcatheter uterine artery embolization. Arch Gynecol Obstet 2009;280(2):305-8.
Thakur YH, Coker A, Morris J, Oliver R. Laparoscopic and ultrasound-guided transcervical evacuation of cornual ectopic pregnancy: an alternative approach. J Obstet Gynaecol 2004;24(7):809-10.
Uccella S, Cromi A, Bogani G, Ghezzi F. Laparoscopic management of cornual pregnancy: minimally invasive surgery reduced the risk for bleeding. Am J Obstet Gynecol 2011;205(6):579.
Ai Z, Wang F, Cao H, Xia Q, Chen X, Cai Y. The value of laparoscopy alone or combined with hysteroscopy in the treatment of interstitial pregnancy: analysis of 22 cases. Arch Gynecol Obstet 2012;285(3):727-32.
Cucinella G, Rotolo S, Calagna G, Granese R, Agrusa A, Perino A. Laparoscopic management of interstitial pregnancy: the “purse-string” technique. Acta Obstet Gynecol Scand 2012;91(8):996-9.
Aust T, O’Neill A, Cario G. Purse-string suture technique to enable laparoscopic management of the interstitial gestation of a heterotopic pregnancy. Fertil Steril 2011;95(1):261-3.