1612 Comparison of Short Term Outcomes after Laparoscopic Salpingostomy Versus Salpingectomy for the Surgical Management of Ectopic Pregnancy

Abstract

Study Objective To investigate the differences in complication rates between laparoscopic salpingostomy and salpingectomy. Design Propensity score matched retrospective cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program database. Patients or Participants Women with surgical management of ectopic pregnancy between 2010-2017. Interventions Laparoscopic salpingectomy and salpingostomy. Measurements and Main Results Of 8,092 ectopic pregnancies, 989 were treated with laparoscopic salpingostomies and matched to laparoscopic salpingectomies at a ratio of 1:2 using propensity scores for the likelihood of undergoing salpingostomy. Propensity scores were calculated using preoperative demographic and clinical characteristics. After matching, no significant differences exist between salpingostomy and salpingectomy in preoperative hematocrit (36.1+/-4.4% vs 35.8+/-4.7%, p=0.91), transfusion rate (1.9% vs 2.0%, p=0.19), age (29.8+/-5.7yrs vs 30.1+/-5.7yrs, p=0.31), and comorbidities (5.8% vs 4.7%). Mean operating times between salpingostomy and salpingectomy showed no difference, (60.7+/-27.2min vs 58.9+/-36.4 min, p=0.78) or conversion to laparotomy (0.2% vs 0.06%, p=0.99). Wound contamination was higher with salpingectomies (3.4% vs 0.02%). The composite complication rate was 10.1%. Postoperative transfusions (6.5% vs 5.8%, p=0.003), reoperation (2.0% vs 0.5%, p Conclusion Laparoscopic salpingostomy is associated with higher risk of complications compared to laparoscopic salpingectomy when treating ectopic pregnancies; though the magnitude of this effect is small given the cohort size. This should be considered when counseling patients on salpingectomy versus salpingostomy.