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Ektopik gebeliklerin laparoskopik yaklaşımla tedavilerinin retrospektif incelenmesi

Retrospective evaluation of the laparoscopic treatment of ectopic pregnancies

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Abstract (2. Language): 
The aim of this study was to evaluate the ectopic pregnancies treated by laparoscopy in our clinic. Demographic characteristics, risk factors, clinical findings and therapeutic approaches of 182 patients treated with the diagnosis of ectopic pregnancy by laparoscopic surgery between June 2003 and September 2010 were retrospectively evaluated. The mean age of the patients was 29.3±3.05 years, the mean number of gravidity and parity was 2.3±1.0 and 1.1±0.9, respectively, and the mean gestational age was 6.2±0.8 weeks. The mean β-HCG levels of the patients on admission was 3880±2510 IU/ml. The most common risk factor was the presence of a previous abdominopelvic surgery (14%), the most frequent admission reason was vaginal bleeding with pelvic pain (40%) and the most frequent preoperative ultrasonographic finding was the presence of an adnexial mass (60%). The most frequent locus of ectopic implants was tubal ampulla (83%), and the most commonly performed treatment modality was laparoscopic salpingectomy (56%). In the treatment of ectopic pregnancies surgical approach was rather preferred than medical therapy in our series, and laparoscopic salpingectomy was the most frequently preferred procedure in cases with tubal damage as also recommended in the current literature.
Abstract (Original Language): 
Bu çalışmanın amacı kiniğimizde laparoskopik cerrahi ile tedavi edilen ektopik gebelik olgularının değerlendirilmesidir. Haziran 2003 ile Eylül 2010 tarihleri arasında ektopik gebelik nedeniyle laparoskopik cerrahi ile tedavi edilmiş olan 182 olgunun demografik özellikleri, risk faktörleri, klinik bulguları ve tedavi yaklaşımları retrospektif olarak incelenmiştir. Hastalarımızın yaş ortalaması 29.3±3.05 yıl olup, gravida ve parite ortalamaları sırasıyla 2.3±1.0 ve 1.1±0.9, ortalama gebelik haftaları ise 6.2±0.8’dir. Hastaların kliniğimize başvuruları sırasındaki ortalama serum β-HCG düzeyleri 3880±2510 IU/ml’dir. En sık saptanan risk faktörü %14 abdominopelvik cerrahi öykü, en sık kliniğe başvuru şikayeti %40 pelvik ağrı ile birlikte gö- rülen vajinal kanama ve en sık preoperatif ultrasonografi bulgusu %60 adneksiyal kitle varlığıdır. Ektopik gebeliklerin en sık yerleşim yeri tubal ampulla (%75) olarak kaydedilmiş ve en sık uygulanan cerrahi tedavi yaklaşımı ise laparoskopik salpenjektomi (%56) olmuştur. Ektopik gebeliklerin tedavisinde cerrahi yaklaşım medikal tedaviye göre daha öncelikli tercihimiz olup, özellikle tubal hasar gelişmiş olgularda önerilen cerrahi girişim olan laparoskopik salpenjektomi en sık uyguladığımız prosedür olmuştur
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