Laparoscopic Appendectomy in Pregnancy

Wu, Jiann‐Ming; Chen, Kuo-Hsin; Lin, Heng-Fu; Tseng, Li-Ming; Tseng, Sheng-Hong; Huang, Shih-Horng

doi:10.1089/lap.2005.15.447

Cited by 50 publications

(30 citation statements)

References 22 publications

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“…3,[51][52][53][54][55][56][57][58][59][60][61][62] Although long-term data on the safety and efficacy of laparoscopic appendectomy during pregnancy are limited, meta-analyzes of observational studies, including a total of more than 500 laparoscopic appendectomies, have shown an increase in the fetal loss rate with this approach, when compared with open appendectomy. 63,64 In a 2012 meta-analysis (11 studies, 3,415 women, 599 in the laparoscopic and 2,816 in the open group), the total relative risk of fetal loss for laparoscopic appendectomy against open surgery in pregnant women was OR 1.91, 95% CI 1.31 to 2.77%.…”

mentioning

confidence: 99%

Acute appendicitis in pregnancy: literature review

Neto

Amorim²,

Nóbrega³

2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneIntroduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms "acute appendicitis" and "pregnancy", in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases.Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video-assisted surgery in these cases remains controversial.

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mentioning

confidence: 99%

Acute appendicitis in pregnancy: literature review

Neto

Amorim²,

Nóbrega³

2015

Rev. Assoc. Med. Bras.

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“…Перинатальные потери при неосложненной форме острого аппендицита состав ляют 2-17%, и возрастают до 19,4-50% при перфорации отрост-ка [10]. Наибольшая летальность при остром де-структивном аппендиците, ослож нен ном распро-страненным перитонитом, наблюдается на позд-них сро ках бере менно сти и составляет 20-50% для матери и 40-90% для плода [11,12].…”

Section: âведениеunclassified

Experience of Treatment of Pregnant Women With Acute Abdomen

Durleshter¹,

Бабенко²,

Дидигов³

et al. 2017

Kuban. nauсh. med. vestnik

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ОПЫÒ ЛЕЧЕНИЯ БЕРЕМЕННЫХ С «ОСÒРЫМ ЖИÂОÒОМ»Материалы и методы. Анализ результатов лечения 183 беременных с острыми хирургиче скими заболевани-ями в условиях двух многопрофильных стациона ров г. Красно дара. Наибо лее часто встречаемыми ургентными хирургиче скими заболевани ями у беременных являются ост рый аппендицит, желчнокамен ная бо лезнь и ее ослож-нения, острый панкреатит, острая кишеч ная непроходи мость.Результаты. Диагностика заболеваний, учитывая контингент боль ных, весьма затрудни тельна и нередко про-должается длительное время, суще ственно ухуд шая прогноз как для ма тери, так и для плода. Использование УЗИ брюш ной поло сти всем пациенткам позволяет уточнить диа гноз и скорректировать так тику лече ния. При сомне нии в диагнозе необходимо выполнять диагностиче скую видеолапароско пию.Заключение. Использование малоинвазивных технологий в лече ние беремен ных позволяют умень шить часто-ту хирургиче ских и связан ных с ними перинаталь ных осложнений, способ ствую т пролонгированию беременно сти и снижению показателей материн ской и перинаталь ной смертно сти. ABSTRACT Aim. To summarize the current experience of diagnosis and treatment of pregnant women with acute abdomen. Materials and methods. Analysis of treatment results of 183 pregnant women with acute abdomen in the conditions of two multidisciplinary hospitals in Krasnodar. The most common urgent surgical diseases in pregnant women are acute appendicitis, cholecystitis and its complications, acute pancreatitis, acute intestinal obstruction.Results. Diagnosis of diseases, providing the contingent of patients, is quite difficult, and often takes a long time, significantly worsening the prognosis for both the mother and the fetus. The ultrasound examination of the abdominal cavity in all patients makes it possible to clarify the diagnosis and adjust the treatment tactics. When doubting the diagnosis, it is necessary to perform diagnostic laparoscopy.Conclusion. The use of minimally invasive technologies in the treatment of pregnant women can reduce the frequency of surgical and associated perinatal complications, promote the prolongation of pregnancy, and reduce maternal and perinatal mortality.

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“…Several retrospective reviews have shown a lack of complications in newborns, including adequate weight for gestation age, well-being at birth [99][100][101] and one prospective paper showing no association with developmental delays of motor, sensory or social skills by 3 years of age [1]. Arguments for laparoscopic appendectomy include improved accuracy of diagnosis and preventing complications related to delayed diagnosis [14,71] in a population with many confounding diagnoses and incorrect preop diagnosis in as many as a quarter of the patients [16,102] as well as ability to identify other intra-abdominal pathology which may mimic appendicitis and harbor fetal loss [96].…”

Section: Controversies In Surgical Managementmentioning

confidence: 99%

Review of Operative vs. Non-Operative Management of Appendicitis in Pregnancy

Blears¹,

Keller²,

Ellis³

2017

Surgery Curr Res

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The last decade has marked a paradigm shift in the care for acute appendicitis in children and non-pregnant adults. Although surgical management remains the safest treatment modality for perforated or complicated appendicitis, antibiotic therapy has been proven to be safe in adult and pediatric patients with non-perforated appendicitis. However, controversy exists for the type of surgery (laparoscopic vs. open) and the post-operative antibiotic regimens which result in optimal patient care of pregnant as well as non-pregnant adults. As several authors have begun to evaluate a non-operative strategy for treating acute appendicitis, whether with antibiotic therapy alone or combined with image-guided percutaneous drainage, others have retrospectively analyzed these strategies to pregnant women with abdominal pain. This collective review presents the epidemiology and diagnostic challenges of acute appendicitis in the pregnant patient and a review of the data that supports non-operative management in non-pregnant adults and pediatric patients as well as the limited data that supports non-operative management in pregnant adults.

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Laparoscopic Appendectomy in Pregnancy

Abstract: Our data support the accumulating evidence that LA is a safe and feasible procedure for the treatment of acute appendicitis in all trimesters of pregnancy. Close maternal and fetal monitoring is essential during and after the operation.

Cited by 50 publications

References 22 publications

Acute appendicitis in pregnancy: literature review

Acute appendicitis in pregnancy: literature review

Experience of Treatment of Pregnant Women With Acute Abdomen

Review of Operative vs. Non-Operative Management of Appendicitis in Pregnancy

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