Histological results of salpingectomy for ectopic pregnancy: A series of 344 tubal pregnancies

Objective: To find out if knowledge of the type, location and extent of histological lesions to the tube might influence the choices for surgical treatment of ectopic pregnancy (EP). Design: Retrospective clinical study. Setting: Department of Gynaecological Surgery, Clinique Universitaire Baudelocque, CHU Cochin Port-Royal, Paris, France. Subjects: Histological study of 344 cases of laparoscopic salpingectomy for EP. Results: The EP was in a proximal location in 14.8% of cases (51 patients) and in a distal location in 85.2% of cases (293 patients). The tube was histologically normal in 17.7% of cases (61 patients). The rate of histologically normal tubes was significantly greater in patients with no past history of tubal problems (28.9%, 22 patients vs. 14.5%, 39 patients; P = 0.0004). In 32.3% of cases (111 patients) tube pathology was bifocal. The rate of bifocal tubal pathologies was significantly greater in cases of proximal EP (45.1%, 23 patients vs. 30%, 88 patients; P = 0.03). Proximal pathology is less often isolated than distal pathology (4.5%, 19 patients, vs. 44.5%, 153 patients). Conclusions: Laparoscopic surgical treatment needs to be more radical (salpingectomy) when the EP is proximal and when the patient presents a past history of tubal surgery and/or infection.