TY  - JOUR
T1  - RÜPTÜRE OLMAMIŞ EKTOPİK GEBELİKLERDE MEDİKAL VE LAPAROSKOPİK CERRAHİ TEDAVİLERİNİN BAŞARISI VE MALİYET ANALİZLERİ
TT  - SUCCESS AND COST ANALYSIS OF METHOTREXATE AND LAPAROSCOPIC SURGERY IN THE TREATMENT OF UNRUPTURED ECTOPIC PREGNANCIES
AU  - Çağlar Aytaç, Pınar
AU  - Parlakgümüş, Huriye Ayşe
AU  - Çok, Tayfun
AU  - Kalaycı, Hakan
AU  - Yalçınkaya, Cem
AU  - Bulgan Kılıçdağ, Esra
PY  - 2013
DA  - July
JF  - Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi
JO  - JGON
PB  - T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi
WT  - DergiPark
SN  - 2667-7849
SP  - 1615
EP  - 1618
VL  - 10
IS  - 39
LA  - tr
AB  - Amaç: Ektopik gebelik tanısı alan hastalarda, rüptüre olmamış ve hemodinamisi stabil olanlara uygulanan medikal ve cerrahi  laparoskopik salpingostomi  tedavilerinin başarılarını ve maliyetlerini karşılaştırdık.Gereçler ve Yöntem: Başkent Üniversitesi Adana Uygulama ve Araştırma Hastanesinde Kadın Doğum ve Hastalıkları Kliniğinde, Ocak 2005-Aralık 2011 tarihleri arasında 201 ektopik gebelik tanısı alan hastadan 81 tanesine medikal tedavi uygulanırken, 28 tanesine laparoskopik salpingostomi uygulandı. Retrospektif olarak iki tedavi grubunun başarılarını ve maliyet analizlerini karşılaştırdık.Bulgular: Medikal ve cerrahi tedavi uygulanan gruplarda başarı oranı, cerrahinin %100 iken, medikal tedavide ise %88.9 olarak saptandı. Cerrahi grupta yatış süresi daha uzun bulundu. Maliyet analizine bakılınca literatürle paralel olarak cerrahide maliyetin belirgin olarak daha yüksek olduğu saptanmıştır.Sonuç: Rüptüre olmamış, hemodinamisi stabil ektopik gebeliklerin tedavisinde metotreksat tedavisi ve laparoscopik salpingostominin mortalite ve morbidite oranı benzerken, medikal tedavinin maliyeti cerrahi tedavi maliyetine göre belirgin olarak düşük olup daha ekonomiktir.
KW  - Ektopik gebelik
KW  - metotreksat
KW  - laparoskopik salpingostomi
KW  - maliyet
N2  - Aim: We retrospectively compare the achievements and costs of medical and surgically laparoscopic salpingostomy in hemodinamically stable, unruptured ectopic pregnancies. Materials and Method: 201 patients with the diagnosis of ectopic pregnancy were treated with medically n:81  or surgically  laparoscopic salpingostomy   n:28  in the Department Obstetrics and Gynecology of Adana Baskent University between January 2005- December 2011. The success and cost analyzes of the two treatment groups were compared retrospectively.Results: In comparison of the treatment groups, the success rate of surgical treatment was found 100%, while medical treatment was found to be 88.9%. Duration of hospitalization was longer in the surgical group. Costanalysis revealed that surgery was more expensive parallel with the literature.Conclusion: As well as mortality and morbidity were similar on both methotrexate and laparoscopic salgingostomy groups, the cost of medical treatment was significantly lower than the surgical treatment in hemodinamically stable small ectopic pregnancy cases.
CR  - Chang J, Elam-Evans LD, Berg CJ, Herndon J,Flowers L, Seed KA, et al. Pregnancy related mortality surveillance-United States, 1991-1999. MMWR Surveill Summ 2003 52:1-8
CR  - Stovall TG, Ling FW Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol 1993 Jun 168(6 Pt1):1759-62.
CR  - Centers for Disease Control. Ectopic pregnancy, United States 1988-1989. MMWR 1992;41:591-4
CR  - Alexander JM, Rouse DJ, Varner E, Austin JM. Treatment of the small unruptured ectopic pregnancy: A cost analysis of methotrexate versus laparoscopy . Obstet Gynecol 1993;88:123-7
CR  - Sowter M, Farquhar C, Petrie K, Gudex G: A randomized trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy. Br J Obstet Gynaecol 2001 108:192–203.
CR  - Mol F, Mol BW, Ankum WM, van der Veen F, Hajenius PJ: Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and metaanalysis. Hum Reprod Update 2008 14(4):309–19.
CR  - Westaby DT, Wu O, Duncan WC, Critchley HO, Tong S, Horne AW. Has increased clinical experience with metotreksat reduced the direct costs of medical management of ectopic pregnancy compared to surgery? BMC Pregnancy Childbirth. 2012 Sep 17;12:98.
UR  - https://dergipark.org.tr/en/pub/jgon/issue//676201
L1  - https://dergipark.org.tr/en/download/article-file/934286
ER  -