SUCCESS AND COST ANALYSIS OF METHOTREXATE AND LAPAROSCOPIC SURGERY IN THE TREATMENT OF UNRUPTURED ECTOPIC PREGNANCIES

Öz

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.

Anahtar Kelimeler

• Ectopic pregnancy,methotrexate,laparoscopic salpingostomy,cost analysis anticoagulation

RÜPTÜRE OLMAMIŞ EKTOPİK GEBELİKLERDE MEDİKAL VE LAPAROSKOPİK CERRAHİ TEDAVİLERİNİN BAŞARISI VE MALİYET ANALİZLERİ

Öz

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.

Anahtar Kelimeler

• Ektopik gebelik,metotreksat,laparoskopik salpingostomi,maliyet

Kaynakça

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