Abstract :
Ectopic pregnancy (EP) remains a significant cause of maternal morbidity and early pregnancy-related mortality. Surgical intervention is often necessary in cases of rupture, hemodynamic instability, or failed medical management. With advancements in laparoscopic techniques, surgical options have shifted, yet the optimal approach—salpingostomy versus salpingectomy—remains debated, particularly regarding reproductive outcomes and complication rates. This review compares the effectiveness, risks, and fertility outcomes of laparoscopic salpingostomy and salpingectomy in the management of EP. A synthesis of recent randomized trials, cohort studies, and meta-analyses was conducted, evaluating surgical success, complications, persistent trophoblastic tissue, recurrence, and subsequent fertility. Both procedures show high initial success. Salpingostomy preserves the fallopian tube and may benefit fertility, especially in bilateral tubal disease, but carries higher risk of persistent trophoblastic tissue and need for follow-up. Salpingectomy eliminates this risk and is preferred when the contralateral tube is healthy. Fertility outcomes are generally comparable when the remaining tube is patent. Laparoscopic approaches reduce morbidity and improve recovery compared to laparotomy but may be limited in low-resource settings. Psychological impacts and long-term care needs remain underemphasized in current protocols. Surgical management of EP should be individualized based on patient stability, fertility goals, and resource availability. Both salpingostomy and salpingectomy are appropriate in selected cases. Expanding access to laparoscopy and integrating psychological support into care pathways are essential for comprehensive management.

Keyword : Ectopic pregnancy, Fertility outcomes, Laparoscopic surgery, Salpingectomy, Salpingostomy.