[Laparoscopic salpingotomy for tubal pregnancy: comparison of linear salpingotomy with and without suturing].

OBJECTIVE To clarify the advantages and the influence to reproductive outcome after laparoscopic salpingotomy with and without suturing for tubal pregnancy. METHODS We retrospectively analyzed the clinical data of patients underwent laparoscopic salpingotomy from March 2012 to October 2014 who were willing to reserve their reproductive function and were able to be followed up. Based on the operation procedure, the patients were assigned to undergo laparoscopic salpingotomy with suturing (group A; n=49) or without suturing (group B; n=69). An amount of 50 mg methopterin was injected at mesosalpinx during operation in all cases. Tubal patency of the trouble side was evaluated by liquid instillation. The operation time, amount of bleeding, the trouble side tubal patency rate 3 months after the surgery, pregnancy outcome 12 months after the surgery was compared between two groups. RESULTS Three months after the surgery the tubal patency rate of trouble side was 85.71% (42/49) in group A and 62.32% (43/69) in group B. There was significant differences (P<0.05) between two groups. Within twelve months of the surgery, the intrauterine gestation rate was 69.39% (34/49) in group A and 42.03% (29/69) in group B. Ectopic re-pregnancy rate of the trouble side was 10.20% (5/49) in group A and 27.54% (19/69) in group B. Secondary infertility rate was 14.29% (7/49) in group A and 27.54% (19/69) in group B. There was significant differences (P<0.05) between two groups. The trouble side tubal patency rate and intrauterine gestation rate of group A was significantly higher than that of group B, while the ectopic re-pregnancy rate of the trouble side and secondary infertility rate of group A was significantly lower than that of group B. CONCLUSIONS Suturing after laparoscopic salpingotomy can decrease the damage to fallopian tube and recover its normal anatomic structure. So the procedure involving suturing can effectively reserve reproductive function for the patients.