title: A cohort study to evaluate the effectiveness of laparoscopic-guided local injection of etoposide in the management of women with unruptured tubal pregnancy.
abstract: OBJECTIVE
  To assess the feasibility of laparoscopic-guided local injection of etoposide or methotrexate (MTX) in the management of unruptured tubal pregnancy and compare the effectiveness of the two regimens.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Medical center.
  
  
  METHODS
  Thirty-one women with laparoscopically diagnosed unruptured tubal pregnancy.
  
  
  METHODS
  A regimen of etoposide 50 mg via laparoscopic-guided local injection (n = 17) compared with a conventional MTX 50 mg regimen (n = 11), after 3 patients were excluded (2 refusals and 1 with salpingostomy).
  
  
  METHODS
  Serial serum β-hCG levels and the success rate in both groups.
  
  
  RESULTS
  General characteristics of the patients were similar in both groups. The overall success rate was 96.4% (27 of 28). The duration between treatment and nadir of serum β-hCG level (<5 mIU/mL) was significantly shorter in the etoposide group than in the MTX group (19.7 ± 13.0 days vs. 33.4 ± 8.1 days). No patient in the etoposide group and only 1 in the MTX group needed reintervention, which led to 100% and 91% success rates for the etoposide and MTX groups, respectively. Three women in the etoposide group had subsequently successful term deliveries.
  
  
  CONCLUSIONS
  Both regimens-etoposide 50 mg and MTX 50 mg via laparoscopic-guided local injection-were acceptable in the management of women with unruptured tubal pregnancy because of their similar and high success rates. More studies are needed to confirm this observation.
authors: Department of Obstetrics and Gynecology, Taipei Medical University Hospital and Taipei Medical University, Taipei, Taiwan.
authors: Ching-Hui
authors: CH
authors: Chen
authors: Wen-Ling
authors: WL
authors: Lee
authors: Li-Hsuan
authors: LH
authors: Chiu
authors: Hsu-Dong
authors: HD
authors: Sun
authors: Wei-Min
authors: WM
authors: Liu
authors: Peng-Hui
authors: PH
authors: Wang
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D015331:Cohort Studies; D005047:Etoposide / Q000008:administration & dosage*; D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D008727:Methotrexate