A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy

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dc.contributor.author Snyman, Leon C.
dc.contributor.author Makulana, T.
dc.contributor.author Makin, J.D.
dc.date.accessioned 2017-03-30T09:07:01Z
dc.date.available 2017-03-30T09:07:01Z
dc.date.issued 2017-03
dc.description.abstract BACKGROUND. Ruptured ectopic pregnancy (REP) is a common gynaecological emergency in resource-poor settings, where laparotomy is the standard treatment despite laparoscopic surgery being regarded as the optimal treatment. There is a lack of prospective randomised data comparing laparoscopic surgery with laparotomy in the surgical management of women with REP. OBJECTIVE. To compare operative laparoscopy with laparotomy in women with REP. METHODS. This was a randomised parallel study. One hundred and forty women with suspected REP were randomised to undergo operative laparoscopy or laparotomy. The outcome measures were operating time, hospital stay, pain scores and analgesic requirements, blood transfusion, time to return to work, and time to full recovery. RESULTS. Operating time was significantly longer in the laparoscopy group (67.3 v. 30.5 minutes, p<0.001). Duration of hospital stay, pain scores and need for analgesia were significantly less in the laparoscopy group. Women in this group returned to work 8 days earlier and their time to full recovery was significantly shorter compared with those in the laparotomy group. Significantly more women undergoing laparotomy required blood transfusion than women in the laparoscopy group. In the latter group, 14.5% of women required blood transfusion compared with 26.5% in the laparotomy group (p=0.01). CONCLUSION. Operative laparoscopy in women treated for REP is feasible in a resource-poor setting and is associated with significantly less morbidity and a quicker return to economic activity. en_ZA
dc.description.department Obstetrics and Gynaecology en_ZA
dc.description.librarian am2017 en_ZA
dc.description.uri http://www.samj.org.za en_ZA
dc.identifier.citation Snyman, LC, Makulana, T & Makin, JD 2017, 'A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy', South African Medical Journal, vol. 107, no. 3, pp. 258-263. en_ZA
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.identifier.other 10.7196/SAMJ.2017.v107i3.11447
dc.identifier.uri http://hdl.handle.net/2263/59588
dc.language.iso en en_ZA
dc.publisher Health and Medical Publishing Group en_ZA
dc.rights This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. en_ZA
dc.subject Recovery en_ZA
dc.subject Ruptured ectopic pregnancy (REP) en_ZA
dc.subject Laparotomy en_ZA
dc.subject Laparoscopic surgery en_ZA
dc.title A randomised trial comparing laparoscopy with laparotomy in the management of women with ruptured ectopic pregnancy en_ZA
dc.type Article en_ZA


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