Comparative Analysis of Laparoscopic Versus Laparotomy Approaches in the Treatment of Ectopic Pregnancy

Author(s): Varsha Ojha, Vinod Kumar Singhal, Faris Dawood Alaswad, Nufra Senopher Mohamed Sarfraz

Background:

Ectopic pregnancy (EP) is a significant risk to life and fertility, occurring when the blastocyst implants outside the uterine cavity and poses significant risks to maternal health. Laparoscopy, a minimally invasive technique, offers benefits like reduced recovery time and less postoperative pain. Conversely, laparotomy, a more invasive surgical method, may be necessary in complex cases.

Aim of the study:

This study aimed to compare the outcome of laparoscopic surgery with laparotomy in the management of ectopic pregnancy.

Methods:

This prospective observational study, conducted over one year at Prime Hospital in Dubai, UAE, examined surgical outcomes in 65 patients with ectopic pregnancies during five years from June 2019 to July 2024. Participants were divided into two groups based on surgical treatment: laparoscopic surgery (n=50) and laparotomy (n=15). Inclusion criteria ensured that participants were adult women with confirmed ectopic pregnancies and complete medical records. The primary technique used was linear salpingostomy under general anesthesia. Data on demographics, clinical parameters, diagnostics, and surgical details were collected via structured questionnaires. Statistical analyses were performed using SPSS (version 26), with significance set at p≤0.05.

Result:

In a study comparing laparoscopic and laparotomy groups, the mean age was 27.8±5.7 years and 30.7±3.6 years, respectively. Parity was higher in the laparoscopy group (2.66±1.8 vs. 1.45±1.2). Both groups had similar beta- HCG levels and gestational ages. BMI was slightly higher in the laparoscopy group, but preoperative hemoglobin levels were lower. Previous surgeries were more common in the laparotomy group (46.67% vs. 20%), as was a history of ectopic pregnancy (46.67% vs. 8%). Operative outcomes showed significant differences: higher blood loss, transfusion rates, and operative time in the laparotomy group. The laparoscopy group had shorter hospital stays (1.32±0.7 days vs. 4.14±1.2 days) and lower complication rates.

Conclusion:

Laparoscopic surgery offers superior outcomes for ectopic pregnancies, including less blood loss, shorter hospital stays, reduced analgesia use, faster recovery, fewer complications, and better fertility preservation. Despite its need for advanced expertise and equipment, laparoscopy is the preferred approach for improved patient outcomes and quicker recovery.