title: Transvaginal endoscopic surgery for tubal ectopic pregnancy.
abstract: OBJECTIVE
  To explore the feasibility, safety, efficacy, and cosmetic outcomes of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy.
  
  
  METHODS
  From May 2009 to May 2012, we prospectively enrolled 40 patients, each of whom had been scheduled for a salpingectomy because of a tubal ectopic pregnancy, and randomized them into two groups: transvaginal endoscopic surgery and laparoscopic approach. We recorded the estimated blood loss, time of anal exhaust, postoperative pain score, length of stay, and scar assessment scale associated with transvaginal endoscopic access (n = 18) (natural orifice transluminal endoscopic surgery) and laparoscopic salpingectomy (n = 20) (control group) for tubal ectopic pregnancy. The transvaginal salpingectomy was performed with a double-channel endoscope through a vaginal puncture. A single surgeon performed the surgical procedures in patients in both groups.
  
  
  RESULTS
  The group that underwent the transvaginal endoscopic procedure reported lesser pain at all postoperative visits than the group that underwent the laparoscopic approach. The duration of time for transvaginal endoscopic surgery was slightly longer than that for the laparoscopic approach. However, there was no statistically significant difference between the two groups in the duration of operative time. The group that underwent transvaginal endoscopic surgery was more satisfied with the absence of an external scar than the group that underwent the laparoscopic procedure, which left a scar. The estimated blood loss, time of anal exhaust, and length of stay were the same in both groups.
  
  
  CONCLUSIONS
  The safety and efficacy of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy are equivalent to those of the laparoscopic procedure. Lesser postoperative pain and a more satisfactory cosmetic outcome were found with the transvaginal endoscopic procedure, making it the more preferred method and superior to the laparoscopic approach.
authors.affiliation: Department of Obstetrics and Gynecology, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Boqun
authors.initials: B
authors.lastname: Xu
authors.affiliation: Institute of Digestive Endoscopy & Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Yawen
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Xia Guan Qu, Nanjing 210011, China. xiaoyanying@yahoo.com.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Ying
authors.affiliation: Department of Obstetrics and Gynecology, Northern Jiangsu People's Hospital, Yangzhou, China.
authors.forename: Zhining
authors.initials: Z
authors.lastname: Fan
mesh_terms: D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000601:surgery*; D012189:Retrospective Studies; D058994:Salpingectomy / Q000379:methods*; D016896:Treatment Outcome; D014621:Vagina