자궁외임신의 치료에 있어서 복강경 수술과 개복술의 비교
A Comparison of Laparoscopy and Laparotomy for the Treatment of Ectopic Pregnancy
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=목적: 산부인과 영역의 흔한 질환인 자궁외임신의 치료에 있어서 복강경 수술과 개복술의 비교분석을 하고자 한다.연구 방법: 2001년 1월 1일부터 2003년 12월 31일까지 본원 산부인과에 내원하여 자궁외임신으로 진단을 받고 수술을 받았던 254명을 대상으로 후향적 고찰을 시행하였다.결과: 자궁외임신으로 수술받았던 총 254명의 환자 중 복강경 수술을 받았던 환자는 179명이었고 개복술을 받았던 75명이었다. 복강경 수술과 개복술을 비교하였을 때 임상적 소견, 검사 소견, 임신부위, 수술방법에서는 유의한 차이가 없었으며 수술소요시간에서는 각각 50.9±10.3분, 52.8±12.1분으로 유의한 차이가 없었으나 입원기간에서는 각각 3.1±0.4일, 6.2±0.7일로 유의한 차이를 보였다. 양군 모두 치료를 요하는 합병증은 발생하지 않았다.결론: 복강경 수술의 대표적 적응증인 자궁외임신의 치료에 있어서 복강경 수술은 개복술을 대체할 수 있는 수술방법으로 사료된다.
Abstract
Objective: To compare the clinical results between laparoscopy and laparotomy for the treatment of ectopic pregnancy. Methods: We studied retrospectively 254 patients who had admitted to Department of Obstetrics and Gynecology, Seoul Sung Ae Hospital and had been treated for ectopic pregnancy from January 1, 2001 to December 31, 2003. Results: A total of 254 patients were randomized to either laparoscopy (n=179) or laparotomy (n=75). There were no significant differences in clinical characteristics and laboratory findings between the two groups. In the both groups, the most common site was the ampullar portion (84.9% vs 73.4%) and the most common operative procedure was the salpingectomy (91.1% vs 88.0%). The mean operation time was not significantly different between the laparoscopy group (50.9±10.3 minutes) and the laparotomy group (52.8±12.1 minutes). But the length of the hospital stay was significantly shorter after laparoscopy (3.1±0.4 days) than after laparotomy (6.2±0.7 days). There were no intraoperative complications in the both groups. Conclusion: In the treatment of ectopic pregnancy, laparoscopic surgery is as effective and safe as the treatment with laparotomy and has the advantage of decrease in hospital stay and cost and of rapid return to normal activity and of cosmetic effect.
참고문헌 (22)
- "New option for diagnosis and treatment of ectopic pregnancy", 267, pp.534~7 (1992)
- "Management of unruptured ectopic gestation by linear salpingostomy randomized clinical trial of laparoscopy versus laparotomy", pp.400~4
- "Current status of endoscopic management of tubal pregnancy", 54, pp.43~6 (1994)
- "A laparoscopic approach can be applied to most cases of ectopic pregnancy", 72, pp.944~7 (1988)
- "Ectopic tubal pregnancy treated by operative laparoscopy", 160, pp.1462~9 (1989)
- "Laparoscopic surgery in ectopic pregnancy:a randomized trial versus laparotomy", 70, pp.343~8 (1991)
- "Novak text book of gynecology", pp.479~93 (1988)
- "Chlamydia trachomatis-associated ectopic pregnancy:serologic and histologic correlates", 165, pp.1076~ (1992)
- "Anatomy and pathology of tubal pregnancy", 67, pp.301~5 (1936)
- "Five cases of extrauterine pregnancy operated upon at the time of rupture", 1, pp.1250~4 (1984)
- "Excision of an ectopic pregnancy through the laparoscope", 117, pp.290~4 (1973)
- "Methotrexate treatment of unruptured ectopic pregnancy:a report of 100 cases", 77, pp.749~3 (1991)
- "Laparoscopic salpingostomy for ectopic pregnancy", 70, pp.948~50 (1987)
- "Laparoscopic treatment of ampullary tubal pregnancy", 5, pp.157~62 (1989)
- "eine efridung zur anschung innerer theile und krankheitennebst abbildung", pp.107~9
- "Endoscopy and its application to the diagnosis and treatment of affections of the genito-urinary passages"
- "als metode bei vaginaler coeliotomie", pp.817~21
- "Ueber die moglichkeity die zystoskopei bei untersuchung seroser hohlungen anzuweden", 57, pp.2090~3 (1910)
- "Laparoscopic treatment of tubal pregnancy", 69, pp.275~9 (1987)
- "Laparoscopic treatment of 109 consecutive ectopic pregnancies", 885, pp.33~7 (1988)
- "management by operative laparoscopy versus laparotomy", pp.23~7
- "Conservative laparoscopic treatment of 321 ectopic pregnancies", 46, pp.1093~7 (1986)