Abstract
Background
Because of limited laboratory and clinical data, no accepted guidelines concerning the safety of laparoscopic appendectomy (LA) in pregnancy have been established yet. In this prospective study, we evaluated the safety and outcome of LA in pregnant women as compared with the same control group of pregnant women who underwent open appendectomy (OA) during the same period.
Methods
During the years 1996 to 1999, 11 consecutive pregnant women (mean age, 27 years; range 21–39 years; gestation age range, 7–34 weeks) who underwent LA were prospectively evaluated and compared with a matched group of 11 women (mean age, 30 years; range 18–42 years; gestation age range, 11–37 weeks) who underwent OA. The following parameters were analyzed: obstetric and gynecologic risk factors, length of procedure, perioperative complications, length of stay, and outcome of pregnancy. Both groups were well matched in age and risk factors for pregnancy loss.
Results
There was no significant difference in the length of procedure (60 vs. 46 min) and the complications rate (one in each group) between the LA and OA groups, respectively. There was no conversion in the LA group. The length of postoperative stay was shorter in the LA group (3.6 vs 5.2 days; p=0.05). There was no fetal loss or other adverse outcome of pregnancy in either group, and all the women in both groups had normal full-term delivery. The infants’ development was normal in both groups for a mean follow-up period of 30 months.
Conclusions
According to this relatively small-scale study laparoscopic appendectomy in pregnant women may be as safe as open appendectomy. This procedure is technically feasible in all trimesters of pregnancy and associated with the same known benefits of laparoscopic surgery that nonpregnant patients experience.
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References
Amos JD, Schorr SJ, Norman PF, Poole GV, Thomae KR, Mancino AT, Hall TJ, Scott Conner CE (1996) Laparoscopic surgery during pregnancy. Am J Surg 171: 435–437
Barnard JM, Chaffin D, Droste S, Tierney A, Phernetton T (1995) Fetal response to carbon dioxide pneumoperitoneum in the pregnant ewe. Obstet Gynecol 85: 669–674
Bennett TL, Estes N (1993) Laparoscopic cholecystectomy in the second trimester of pregnancy: a case report. J Reprod Med 38: 833–834
Cruz AM, Southerland LC, Duke T, Townsend HG, Ferguson JG, Crone LA (1996) Intra-abdominal carbon dioxide insufflation in the pregnant ewe: uterine blood flow, intra-aminiotic pressure, and cardiopulmonary effects. Anesthesiology 85: 1395–1402
Curet MJ, Allen D, Josloff RK, Pitcher DE, Curet LB, Miscall BG, Zucker KA (1996) Laparoscopy during pregnancy. Arch Surg 131: 546–550
Curet MJ, Vogt DA, Schob O, Qualls C, Izquierdo LA, Zucker KA (1996) Effects of CO2 pneumoperitoneum in pregnant ewes. J Surg Res 63: 339–344
Gannedahl P, Odeberg S, Brodin LA, Sollevi A (1996) Effects of posture and pneumoperitoneum during anaesthesia on the indices of left ventricular filling. Acta Anaesthesiol Scand 40: 160–166
Gurbuz AT, Peetz ME (1997) The acute abdomen in the pregnant patients: Is there a role for laparoscopy? Surg Endosc 11: 98–102 DOI: 10.1007/s004649900306
Ho HS, Saunders CJ, Gunther RA, Wolfe BM (1995) Effector of hemodynamics during laparoscopy: CO2 absorption or intraabdominal pressure?. J Surg Res 59: 497–503
Hunter JG, Swanstron L, Thornburg K (1995) Carbon dioxide pneumoperitoneum induces fetal acidosis in a pregnant ewe model. Surg Endosc 9: 272–277
Ivankovich AD, Miletich DJ, Albrecht RF, Heyman HJ, Bonnet RF (1975) Cardiovascular effects of intraperitoneal insufflation with carbon dioxide and nitrous oxide in the dog. Anesthesiology 42: 281–287
Joris JL, Noirot DP, Legrand MJ, Jacquet NJ, Lamy ML (1993) Hemodynamic changes during laparoscopic cholecystectomy. Anesth Analg 76: 1067–1071
Joshi GP, Hein HAT, Ramsay MAE, Foreman ML (1996) Hemodynamic response to anesthesia and pneumoperitoneum in orthotopic cardiac transplant recipients. Anesthesiology 85: 929–933
Kashtan J, Green JF, Parsons EQ, Holcroft JW (1981) Hemodynamic effect of increased abdominal pressure. J Surg Res 30: 249–255
Motew M, Ivankovich AD, Bieniarz J, Albrecht RF, Zahed B, Scommegna A (1973) Cardiovascular effects and acid-base and blood gas changes during laparoscopy. Am J Obstet Gynecol 115: 1002–1012
Schreiber JH (1987) Early experience with laparoscopic appendectomy in women, Surg Endosc 1: 211–216
Schreiber JH (1990) Laparoscopic appendectomy in pregnancy. Surg Endosc 4: 100–102
Schwartzberg BS, Conyers JA, Moore JA (1997) First trimester of pregnancy laparoscopic procedures. Surg Endosc 11: 1216–1217
Vaizey CJ, Jacobson MJ, Cross FW (1994) Trauma in pregnancy. Br J Surg 81: 1406–1415
Westerband A, Van-De WJ, Amzallag M, Lebowitz PW, Nwasokwa ON, Chardavoyne R, Abou TA, Wang X, Wise L (1992) Cardiovascular changes during laparoscopic cholecystectomy. Surg Gynecol Obstet 175: 535–538
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Online publication: 6 February 2001
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Lyass, S., Pikarsky, A., Eisenberg, V.H. et al. Is laparoscopic appendectomy safe in pregnant women?. Surg Endosc 15, 377–379 (2001). https://doi.org/10.1007/s004640000368
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DOI: https://doi.org/10.1007/s004640000368