A Systematic Review and Meta-analysis of Laparotomy Compared with Laparoscopic Management of Cornual Pregnancy

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.

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