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A Systematic Review and Meta-analysis of Laparotomy Compared with Laparoscopic Management of Cornual Pregnancy
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  • Greg Marchand,
  • Ahmed Masoud,
  • Katelyn Sainz,
  • Ali Azadi,
  • Kelly Ware,
  • Janelle Vallejo,
  • Sienna Anderson,
  • Alexa King,
  • Asya Osborn,
  • Stacy Ruther,
  • Giovanna Brazil,
  • Kaitlynne Cieminski,
  • Sophia Hopewell,
  • Lisa Rials,
  • Akarshi Brar
Greg Marchand
Marchand Institute for Minimally Invasive Surgery
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Ahmed Masoud
Fayoum University Faculty of Medicine
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Katelyn Sainz
Marchand Institute for Minimally Invasive Surgery
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Ali Azadi
Star Urogynecology
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Kelly Ware
Marchand Institute for Minimally Invasive Surgery
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Janelle Vallejo
Marchand Institute for Minimally Invasive Surgery
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Sienna Anderson
Marchand Institute for Minimally Invasive Surgery
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Alexa King
Marchand Institute for Minimally Invasive Surgery
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Asya Osborn
Marchand Institute for Minimally Invasive Surgery
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Stacy Ruther
Marchand Institute for Minimally Invasive Surgery
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Giovanna Brazil
Marchand Institute for Minimally Invasive Surgery
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Kaitlynne Cieminski
Marchand Institute for Minimally Invasive Surgery
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Sophia Hopewell
Marchand Institute for Minimally Invasive Surgery
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Lisa Rials
Marchand Institute for Minimally Invasive Surgery
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Akarshi Brar
Star Urogynecology
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Abstract

Background: Cornual (or interstitial pregnancy) is a rare but life-threatening condition with an incidence of about 1-4% of all types of tubal ectopic pregnancies. It can be managed by open and minimally invasive surgical techniques. Therefore, we aim to compare between laparoscopy and traditional open surgery for managing interstitial pregnancy. Methods: We systematically searched PubMed, Scopus, Web of Science, and Cochrane till May 2020 using relevant keywords and screened retrieved studies for eligibility. Data were extracted from the relevant articles and were pooled as mean difference (MD) or relative risk (RR) with a 95% confidence interval (CI), using Review Manager Software for continuous outcomes and OpenMeta [Analyst] software for windows for dichotomous outcomes. Results: We included four studies, three of which provided data eligible for meta-analysis. The duration of postoperative hospital stay was lower in the laparoscopic surgery group (MD = -1.42, 95% CI [-1.72, -0.76], P < 0.0001). There were no significant difference between laparoscopy and traditional open surgery in operative time (MD = -11.22, 95% CI [-42.44, 20], P = 0.48), blood loss (MD = -9.43, 95% CI [-214.18, 195.32], P = 0.93), post and intraoperative complications (RR = 1.543, 95% CI [0.201, 11.849], P = 0.677), and need for blood transfusion (RR = 0.774, 95% CI [0.497, 1.251], P = 0.296). Conclusion: Laparoscopic surgery is associated with lower postoperative hospital stay duration with no difference in terms of operation time, blood loss, post, and intraoperative complications, and need for blood transfusion compared with laparotomy.