Inovative Surgical Treatment for Intratubal Administration of Methotrexate

Aneta Tomescu, Cezar Laurentiu Tomescu and Rodica Sîrbu
Additional contact information
Aneta Tomescu: "Ovidius" University of Constanţa, Faculty of Medicine, Constanta, Romania
Cezar Laurentiu Tomescu: "Ovidius" University of Constanţa, Faculty of Medicine, Constanta, Romania
Rodica Sîrbu: "Ovidius" University of Constanţa, Faculty of Pharmacy, Constanta, Romania

European Journal of Medicine and Natural Sciences, 2022, vol. 5, issue 1, 21-28

Abstract: In patients where conservative medical treatment with methotrexate failed, surgical intervention was necessary. The personal surgical method was performed on a number of 9 patients; the surgical intervention was a conservative method – salpingorraphy. In order to prevent persistent gestational throphoblastic disease and tubal clogging, a polyethylene catheter is introduced in the oviduct until it reaches the ostium of the Fallopian tube, without exceeding it. In order to ensure a rigorous haemostasis, the Fallopian tube and the polyethylene catheter are sutured together. The level of HCG is measured in the fourth and seventh day postoperative: if the levels of HCG are higher than 1000 mUI/ml, if they plateau or if they have increased, methotrexate is administered intraluminally through the polyethylene tube, according to the following scheme: 50 mg of methotrexate are dissolved in 10 ml of physiological saline solution and injected through the polyethylene catheter, for 5 days. 10 mg per day in 2 doses (5 mg in the morning and 5 mg in the evening).If the values of HCG decrease to an adequate level and there is no risk of persistent throphoblastic disease, the polyethylene catheter is kept for 8-12 days, afterwards it is extracted by traction. If the values do not decrease accordingly, the intraluminal administration of methotrexate is resumed after a 3-day break. This method was used on a number of 9 patients; 4 of them had been treated with methotrexate before the surgical intervention and pertain to the study, and 5 of them had been operated on for complications of ectopic pregnancy and were suitable for this kind of surgical intervention. No postoperative complications or deaths were recorded.

Keywords: ectopic pregnancies; methotrexate; Human Chorionic Gonadotrophin Hormone. (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://mentisia.org/files/articles/ejmn_v5_i1_22/Tomescu.html (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eur:ejmnjr:26

DOI: 10.26417/ejis.v1i3.p53-58

Access Statistics for this article

More articles in European Journal of Medicine and Natural Sciences from Mentisia
Bibliographic data for series maintained by Mentisia ().