Salpingotomy versus salpingectomy in women with tubal pregnancy (European surgery in ectopic pregnancy study): an open-label, multicenter, randomized controlled trial

Editorial commentThe standard surgical procedure for treatment of tubal ectopic pregnancy is salpingectomy, in which the affected fallopian tube is removed. A feasible alternative intervention, salpingotomy, has been promoted since 1957. With this procedure, the pregnancy is removed while the affected tube is preserved. There are 2 risks associated with salpingotomy: a repeated ectopic pregnancy in the same tube and a persistent trophoblast requiring additional treatment. Despite these potential drawbacks, salpingotomy has been widely used and often preferred over salpingectomy because it has been assumed that preservation of both tubes increased the prospects for a future pregnancy. However, limited data support this assumption, and it remains unclear whether the potential benefits of salpingotomy outweigh the risks. The aim of this open-label, multicenter, randomized controlled trial was to determine whether salpingotomy improves rates of ongoing pregnancy by natural conception compared with salpingectomy.Femke Mol, Norah M. van Mello, Annika Strandell, Karin Strandell, Davor Jurkovic, Jackie Ross, Kurt T. Barnhart, Tamer M. Yalcinkaya, Harold R. Verhoeve, Giuseppe C.M. Graziosi, Carolien A.M. Koks, Ingmar Klinte, Lars Hogström, Ineke C.A.H. Janssen, Harry Kragt, Annemieke Hoek, Trudy C.M. Trimbos-Kemper, Frank J.M. Broekmans, Wim N.P. Willemsen, Willem M. Ankum, Ben W. Mol, Madelon van Wely, Fulco van der Veen, and Petra J. Hajenius, for the European Surgery in Ectopic Pregnancy, ESEP, Study Grou

Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial

Background tubal ectopic pregnancy can be surgically treated by salpingectomy, in which the affected fallopian tube is removed, or salpingotomy, in which the tube is preserved. Despite potentially increased risks of persistent trophoblast and repeat ectopic pregnancy, salpingotomy is often preferred over salpingectomy because the preservation of both tubes is assumed to offer favourable fertility prospects, although little evidence exists to support this assumption. We aimed to assess whether salpingotomy would improve rates of ongoing pregnancy by natural conception compared with salpingectomy