The Feasibility and Advantages of Laparoscopic Ectopic Pregnancy Surgery at a Secondary Level Hospital in South Africa. A Clinical Article
Ectopic pregnancy is a gynaecological emergency that impacts maternal morbidity worldwide. Laparoscopic surgery remains the preferred method of surgical management for majority of patients. Not only has it been proven to improve patient outcomes and overall care, but also cost effective and efficient.
Primary objective is to show the feasibility of laparoscopic ectopic pregnancy surgery management at a secondary level hospital, by determining the rates and compare several variables of laparoscopy with laparotomy management to assess outcomes.
A retrospective study design was used. Patients who presented to Worcester Provincial Hospital with suspected ectopic pregnancy and underwent surgical management were included. The required sample size was 81 patients. Data was collected using online records and theatre reports. Participants were assigned into two cohort groups based on method of surgical management and compared.
84 cases were identified, of which 48 (57.1%) were managed laparoscopically and 36 (42.9%) with laparotomy. Average surgical time was 34.6 minutes and 44.9 minutes for the laparotomy group and laparoscopy group respectively. Average hospital-stay and post operation analgesia were significantly less in the laparoscopy group compared to the laparotomy group.
This study shows not only can a secondary hospital in South Africa achieve high income country laparoscopy treatment rates, but also that it is feasible and has significantly better outcomes for the patient in terms of pain management and decreased hospital stay. The benefit of laparoscopic surgery make’s this treatment modality the treatment of choice, if surgical intervention is required.
Denise Armatas, Registrar at Tygerberg Hospital, in obstetrics and gynaecology department in the faculty of health sciences at Stellenbosch University
Gerhardus Barnard Theron, Emerilus Professor in the department of Obstetrics and gynaecology at Tygerberg Hospital, Faculaty of health sciences Stellenbosch Hospital, Cape Town
Ramon Aronis, Previous consultant in obstetrics and gynaecology at Worcester Provincial Hospital.
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Date published: 2019-10-28
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