Histological results of salpingectomy for ectopic pregnancy: a series of 344 tubal pregnancies

Objective

To find out if knowledge of the type, location and extent of histological lesions to the tube might influence the choices for surgical treatment of ectopic pregnancy (EP).

Design

Retrospective clinical study.

Setting

Department of Gynaecological Surgery, Clinique Universitaire Baudelocque, CHU Cochin Port-Royal, Paris, France.

Subjects

Histological study of 344 cases of laparoscopic salpingectomy for EP.

Results

The EP was in a proximal location in 14.8% of cases (51 patients) and in a distal location in 85.2% of cases (293 patients). The tube was histologically normal in 17.7% of cases (61 patients). The rate of histologically normal tubes was significantly greater in patients with no past history of tubal problems (28.9%, 22 patients vs. 14.5%, 39 patients; P = 0.0004). In 32.3% of cases (111 patients) tube pathology was bifocal. The rate of bifocal tubal pathologies was significantly greater in cases of proximal EP (45.1%, 23 patients vs. 30%, 88 patients; P = 0.03). Proximal pathology is less often isolated than distal pathology (4.5%, 19 patients, vs. 44.5%, 153 patients).

Conclusions

Laparoscopic surgical treatment needs to be more radical (salpingectomy) when the EP is proximal and when the patient presents a past history of tubal surgery and/or infection.