title: Laparoscopic salpingostomy versus laparoscopic local methotrexate injection in the management of unruptured ectopic gestation.
abstract: OBJECTIVE
  Our goal was to determine whether laparoscopic salpingostomy is preferable to laparoscopic methotrexate injection in the management of unruptured tubal gestation.
  
  
  METHODS
  Forty-eight patients with unruptured tubal pregnancy were prospectively randomized to either laparoscopic salpingostomy or laparoscopic local methotrexate injection in a university medical center. Operation time, duration of hospital stay, decrease in levels of beta-human chorionic gonadotropin, and fertility outcome were compared between the two groups.
  
  
  RESULTS
  The salpingostomy group had a longer operative time (p < 0.0001) but a shorter hospital stay (p < 0.01) and a lower incidence of persistent trophoblastic activity (5% vs 14%), although this difference did not reach statistical significance. The time interval until beta-human chorionic gonadotropin disappearance was similar (13.9 and 13.7 days), and the subsequent intrauterine pregnancy rate was similar in the two groups (83.5% and 81%). One repeat tubal pregnancy occurred in the salpingostomy group.
  
  
  CONCLUSIONS
  Both these methods of conservative management are equally effective and each one has its merits.
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: U
authors.initials: U
authors.lastname: Zilber
authors.forename: M
authors.initials: M
authors.lastname: Pansky
authors.forename: I
authors.initials: I
authors.lastname: Bukovsky
authors.forename: A
authors.initials: A
authors.lastname: Golan
mesh_terms: D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005298:Fertility; D006801:Humans; D007267:Injections; D010535:Laparoscopy; D007902:Length of Stay; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000601:surgery*; D011446:Prospective Studies; D012489:Salpingostomy; D016896:Treatment Outcome
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate