The feasibility and advantages of laparoscopic surgery for ectopic pregnancy at a secondary hospital in South Africa

Abstract

Background. Ectopic pregnancy (EP) is a gynaecological emergency with implications for maternal morbidity worldwide. Laparoscopic surgery is the preferred method of surgical management in most cases, as it has been shown to improve patient outcomes and overall care and to be cost effective and efficient.  Objectives. To investigate the feasibility of laparoscopic surgery for EP management at a secondary hospital, based on incidence rates and comparing surgery-associated variables and outcomes with those in laparotomy.  Methods. A retrospective study design was used. All patients who were treated surgically for EP at the Worcester Provincial Hospital were included. The required sample size was 81. Data were collected from patient files and theatre reports. Cases were assigned to one of two cohorts based on the method of surgical management.  Results. A total of 84 cases were identified, of which 48 (57.1%) were managed laparoscopically and 36 (42.9%) with laparotomy. The average surgical time was 34.6 minutes and 44.9 minutes for a laparotomy and a laparoscopy, respectively. Patients who were treated laparoscopically required significantly less postoperative pain relief and had shorter hospital stays.  Conclusion. This study shows not only that laparoscopy treatment is a feasible option for EP in a secondary-hospital setting in South Africa, but also that the intervention is associated with significantly better patient outcomes than laparotomy. The demonstrated benefits make laparoscopy the preferred treatment modality for EP when surgical intervention is required.