Outcomes after open and laparoscopic appendectomy during pregnancy: A meta-analysis

Prodromidou, Anastasia; Machairas, Nikolaos; Kostakis, Ioannis D.; Molmenti, Ernesto P.; Spartalis, Eleftherios; Kakkos, Athanasios; Lainas, Georgios T.; Sotiropoulos, Georgios C.

doi:10.1016/j.ejogrb.2018.04.010

Cited by 48 publications

(44 citation statements)

References 48 publications

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“…In a systematic review of 20 studies, Prodromidou et al [7] reported that the length of stay of LA is 1 day shorter than that of OA. [7] We think that our result might be due to preoperative and postoperative consultations to assess the mother and fetus regardless of the surgical intervention. In addition, the diagnostic tools that we used to ensure the diagnosis of appendicitis, such as US and MRI, take some time.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open appendectomy in pregnancy: A single center experience

Gök

Soydaş²,

Bayraktar³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The aim of this study was to compare the obstetric and surgical outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) performed for pregnant women at a single center. It was the hypothesis of this study that there would be no significant difference in the results. METHODS: The medical records of 57 consecutive pregnant women who underwent an appendectomy between January 2009 and September 2018 were reviewed retrospectively. The patients were divided into 2 groups: OA and LA. The collected data included age, gestational age, diagnostic modalities used, duration of surgery, length of hospital stay, morbidity, and mortality. RESULTS: Eighteen (31%) patients underwent LA and 39 (69%) patients underwent OA. There were no significant differences in the demographic data. The duration of surgery was significantly less in the laparoscopic group (37 vs 57 minutes; p=0.005). There were no statistically significant differences in the outcomes of deep or superficial surgical site infection, length of hospital stay, pre-term delivery, or loss of the fetus. There was no mortality in either group. CONCLUSION: The results of this study suggest that LA can be a safe option for both the pregnant patient and the child. Further prospective, randomized studies with a larger group of pregnant patients with appendicitis are needed to fully determine the effects of laparoscopy in these circumstances.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open appendectomy in pregnancy: A single center experience

Gök

Soydaş²,

Bayraktar³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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show abstract

“…This finding is consistent with previous studies and meta-analyses. [ 5 , 19 , 20 ] However, Maimaiti et al recently reported a significantly shorter operative time in the LA group than in the OA group. [ 21 ] In our study, we found that in the first 2 cases, the operative time was over 100 minutes; however, the operative time in the last 2 patients was shortened to only 30 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] On the other hand, according to the current guidelines and a meta-analysis, traditional open appendectomy (OA) is still recommended for pregnant patients over LA, which might be associated with higher rates of fetal loss. [ 5 – 7 ] However, most of the included studies were small, and the selection bias was very high; therefore, whether LA should be chosen for pregnant patients is still under debate.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic appendectomy is safe and feasible in pregnant women during second trimester

et al. 2020

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Acute appendicitis (AA) is the most common nonobstetric surgical emergency during pregnancy. According to the current guidelines and meta-analyses, traditional open appendectomy (OA) is still recommended for pregnant patients over laparoscopic appendectomy (LA), which might be associated with higher rates of fetal loss. Previous studies and experiences indicated that LA might be safe in the second trimester of pregnancy. The current study aimed to evaluate the safety and feasibility of LA in pregnant women during the second trimester. At our institution, a retrospective study was conducted with pregnant patients who underwent LA or OA during the second trimester between January 2016 and August 2018. A total of 48 patients were enrolled. Of them, 12 were managed with laparoscopy and 36 with the open approach. We found that the LA group had higher BMIs than the OA group (4.0 ± 4.3 vs 21.5 ± 2.9, P = .031). The financial results showed that the average daily medical costs for patients who underwent LA was higher than those who underwent OA (444 ± 107 US$ vs 340 ± 115 US$, P = .009), while the total cost of hospitalization was comparable between the 2 approaches. The perioperative and obstetric outcomes were comparable between LA and OA. In each group, only 1 patient had fetal loss. No “Yinao” was found in any of the patients in the LA group. In this study, with the proven advantages of the laparoscopic techniques, LA was found to be safe and feasible for pregnant women during the second trimester.

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“…Although non-operative treatment of acute appendicitis continues to be explored within the general population, appendectomy remains the main stay of treatment for acute appendicitis in pregnant women. 8,9 Laparoscopic appendectomy is the preferred approach for the treatment of acute appendicitis in the pregnant patient. 3,11 Initial port placement should consider the uterine fundal height, and the surgeon should rely upon the entry technique with which he or she is most experienced and…”

Section: Treatmentmentioning

confidence: 99%

Surgical Emergencies in the Pregnant Patient

Selzer

Stefanidis

2019

Advances in Surgery

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Synopsis: One in 500 to 700 pregnancies in the United States are complicated by an abdominal emergency necessitating surgery. Addressing these emergencies during pregnancy presents several decision making challenges and commonly calls into question the appropriate approach for evaluation and definitive care. Ultimately, surgical intervention can be performed safely during pregnancy independent of trimester and offers definitive therapy and a quicker recovery when performed laparoscopically.

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Outcomes after open and laparoscopic appendectomy during pregnancy: A meta-analysis

Cited by 48 publications

References 48 publications

Laparoscopic versus open appendectomy in pregnancy: A single center experience

Laparoscopic versus open appendectomy in pregnancy: A single center experience

Laparoscopic appendectomy is safe and feasible in pregnant women during second trimester

Surgical Emergencies in the Pregnant Patient

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