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.