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Appendectomy during early pregnancy: what is the preferred surgical approach? Am Surg 2005 Oct;71(10):809-12

Date

02/14/2006

Pubmed ID

16468524

Scopus ID

2-s2.0-33644959836 (requires institutional sign-in at Scopus site)   45 Citations

Abstract

Appendectomy is the most common nongynecologic surgery performed during pregnancy. Although many surgeons offer laparoscopic appendectomy (LA) as an alternative to open appendectomy (OA) during early pregnancy, few studies have compared the effects of LA versus OA on the fetus and the outcome of the pregnancy. Twenty-eight consecutive females undergoing appendectomy for presumed appendicitis in the first two trimesters of pregnancy between January 2000 and December 2002 were identified retrospectively. Demographic information, weeks of pregnancy at operation, and surgical approach (LA or OA) were recorded. Study outcomes included operative and pregnancy-related complications, length of hospitalization, final outcome of pregnancy, and infant birth weight. Seventeen LA and 11 OA were performed. There were no significant differences in surgical or obstetrical complications, length of hospitalization, or birth weight between the two groups. Two cases of postoperative fetal demise were noted in the LA group. Although not statistically significant, the two fetal losses in the laparoscopic group are concerning. The current study did not demonstrate any advantages to the laparoscopic approach. Pending further investigation, the open approach may be preferred for appendectomy in pregnant patients during the first two trimesters of pregnancy.

Author List

Carver TW, Antevil J, Egan JC, Brown CV

Author

Thomas W. Carver MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Appendectomy
Appendicitis
Female
Humans
Laparoscopy
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Pregnancy Trimester, First
Pregnancy Trimester, Second
Retrospective Studies