Conclusion of the study Results Investigations Type of Traditional surgery, (n) Type of Laparoscopic surgery, (n) Total cases n Participants and main inclusion criteria Sites and time Study design Study ID
Laparoscopic cornual resection is a feasible approach with favorable surgical and long-term pregnancy outcomes.
Compared with laparotomy, laparoscopic cornual section showed shorter operative time (median 40 vs. 70 min), less blood loss (150 vs. 400 ml) and shorter hospital stay (2 vs. 4 days).
Transvaginal ultrasound scan
Laparotomy with cornual resection, (3)
Laparoscopic cornual resection, (7)
17
Patients with intrauterine pregnancy along with feature of a co-existing interstitial pregnancy: - A gestational sac visualized high in the fundus. - not surrounded by 5 mm of myometrium in all planes. -a gestational sac seen separately and < 1 cm from the most lateral edge of the uterine cavity. Nanjing Drum Tower Hospital, China. Records from July 2010 to December 2015
Retrospective analysis
Jiang 2018 (32)
Laparoscopic cornual resection is a safe and less invasive procedure with a reasonable complication rate and shorter hospital stay.
There were no statistically significant differences between the two groups for the mean operation time, estimated blood loss, blood loss of more than 1000 mL, blood transfusion requirements, and complications. The mean number of postoperative hospital days was shorter in the laparoscopy group than in the laparotomy group (4.53 ± 1.44 days versus 5.89 ± 1.86 days, respectively; P < 0.001).
Transvaginal ultrasound scan
Open cornual resection, (54)
Laparoscopic cornual resection, (34)
88
Patients with interstitial pregnancy who were treated with open cornual resection or laparoscopic cornual resection.
The Korea University Medical Center, South Korea. Records from January 1998 to October 2009
Retrospective analysis
Hwang 2010 (26)
Laparoscopic cornual resection (cornuotomy) is a safe and less invasive procedure with a comparable complication rate. It has shown that it is feasibility and should be considered as initial treatment in managing those cases in trained hand surgeons.
The duration of hospitalization and mean operating time were both significantly shorter in the LC group than in the OC group (1.43 ± 0.54 versus 2.57 ± 0.79 and 61.4 ± 15.7 min versus 97.1 ± 38.2 min, respectively, P < 0.05).There were no statistically significant differences between both groups for the estimated blood loss, requirement of blood transfusion, complications, and future fertility.
Physical examination, transvaginal sonography, full blood count, and serum human chorionic gonadotrophin (hCG) levels.
Open cornuotomy, (7)
Laparoscopic cornuotomy, (7)
14
Patients with interstitial pregnancy who were treated with open cornual resection or laparoscopic cornual resection.
Putrajaya Hospital, Putrajaya, Malaysia. Records from January 2005 to December 2014,
Retrospective cohort
Ghazali 2018 (27)
A change from diagnosis later in pregnancy and laparotomy to more conservative treatment, mainly by laparoscopy, suggests a possibly better subsequent pregnancy rate. The first four women, with significant hemoperitoneum, were treated by laparotomy. Of the next 10 women, four were selected for medical treatment with methotrexate. Only one case was treated successfully. The other six women had laparoscopic treatment. Of nine laparoscopies, one was converted to laparotomy due to excessive blood loss during the procedure. Of nine women desiring a child, three were infertile, whereas six conceived with an intrauterine pregnancy.
Transvaginal ultrasound scan
Laparotomy, (5)
Laparoscopy cornuostomy, encircling, or salpingectomy, (8)
14
Patients with interstitial pregnancy who were treated with laparotomy, medical treatment with systemic methotrexate, or laparoscopy.
Wolfson Medical Center, Holon, and 2Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Records from June 1997 to June 2007.
Retrospective cohort
Sagiv 2013 (22)
Ipsilateral salpingectomy, previous ectopic pregnancy, and in vitro fertilization are predisposing factors for interstitial pregnancy. Contrary to previous belief, rupture of interstitial pregnancy occurs relatively early in pregnancy. In selected patients, laparoscopic cornual excision is a viable treatment option.
Persistently elevated serum human chorionic gonadotropin levels were found in one patient after laparoscopic cornual excision, and she was successfully treated with methotrexate. Fourteen cases (43.7%) of rupture of interstitial pregnancy were found. This included five cases (15.6%) of heterotopic pregnancy; all were the results of in vitro fertilization, and all ruptured at the time of diagnosis. Subsequent pregnancy was achieved in ten patients. No uterine rupture was encountered during pregnancy or labor
Transvaginal ultrasound scan and diagnostic laparoscopy and laparotomy.
Laparotomy, (13)
Laparoscopy, (11)
32
Patients with interstitial pregnancy who were treated with laparotomy, methotrexate, or laparoscopy.
- Cases from 1999 to 2002.
Cross sectional
Tulandi 2004 (23)
Progressively conservative surgical measures are being used to treat interstitial pregnancy successfully, with no negative impact on subsequent pregnancies. Subsequent successful reproductive outcomes are presented. Transvaginal ultrasound scan and diagnostic laparoscopy Cornuostomy by laparotomy, (1) Laparoscopic cornuostomy and removal of products of conception, (3) 4 Cases of interstitial ectopic pregnancy - Case series Warda 2014 (24)