Reduced-port laparoscopic appendectomy for acute appendicitis in pregnancy

Hata, Tsuyoshi; Hayashi, Nobuyasu; Urabe, Shoichiro; Hayashi, Kôji; Nakagawa, Takuro; Michiura, Toshiya; Yamabe, Kazuo

doi:10.1093/jscr/rjaa097

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…El tratamiento definitivo de la apendicitis es la apendicectomía, pero previamente a la cirugía se debe evaluar el bienestar fetal. Existe en la actualidad discrepancias en el abordaje quirúrgico, cuando se opta por un acceso abierto se recomienda realizar incisiones transversas en el cuadrante inferior derecho, u oblicuas, como la descrita por McBurney, que permite su extensión, según los hallazgos intraoperatorias en caso de alta sospecha de peritonitis generalizada se recomienda emplear la incisión en la línea media, aunque en el último trimestre el útero puede dificultar la exploración abdominal (30).…”

Section: Abordaje Quirúrgico Abiertounclassified

Revisión de los protocolos sobre abdomen agudo quirúrgico no obstétrico en el embarazo.

Chacón-Flores,

Muñoz-Cajilima

2023

MQRInvestigar

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Introducción: Durante el embarazo, la mujer puede presentar patología quirúrgica no ginecológica, misma que se asocia con elevada morbimortalidad por cada hora en el retraso diagnóstico, en la actualidad no existe suficientes protocolos dirigidos para cada patología quirúrgica en el embarazo, situación que a largo plazo afecta el adecuado manejo de la patología abdominal quirúrgica en la mujer embarazada. Metodología: Es un estudio de revisión bibliográfica tipo narrativa, una revisión amplia de la literatura, sobre los protocolos sobre agudo quirúrgico no obstétrico en el embarazo en bases de datos científicas, como Pub Med, Scielo, Biblioteca Cochrane, y Science Direct, mediante parte de la estrategia PRISMA. Resultados: Se revisaron 50 estudios, que recopilaron las principales recomendaciones sobre los protocolos sobre agudo quirúrgico no obstétrico en el embarazo Conclusiones: la patología abdominal quirúrgica no obstétrica en la mujer embarazada es un tema de relevancia, puesto que se asocia con elevada morbimortalidad, en la actualidad a pesar de que no se cuenta con protocolos específicos para el manejo de cada patología en el embarazo, por lo que es importante poder realizarlos para disminuir el tiempo de retraso y, por lo tanto, las complicaciones en la mujer embarazada.

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Section: Abordaje Quirúrgico Abiertounclassified

Revisión de los protocolos sobre abdomen agudo quirúrgico no obstétrico en el embarazo.

Chacón-Flores,

Muñoz-Cajilima

2023

MQRInvestigar

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Laparoscopic appendectomy with left lateral tilt in pregnant women in the second and third trimesters: A clinical case series in a single Vietnam centre

Học

Sơn

Long

et al. 2021

International Journal of Surgery Open

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Introduction: The presentation of acute appendicitis during pregnancy may cause diagnostic and therapeutic difficulty. Laparoscopic appendectomy (LA) is widely accepted as a minimally invasive procedure for acute appendicitis. However, LA during the second and third trimesters is associated with problems, including technical difficulty, a risk of foetal loss and preterm delivery. Method: Clinical data were retrospectively collected and analysed between April 2016 and April 2021. A telephone questionnaire was administered in cases of missing data. The clinical information obtained included a detailed medical and obstetric history; preoperative, intraoperative, and postoperative data; complications; and pregnancy outcomes. Results: There were a total of eighteen patients in the 2nd and 3rd trimesters who had undergone emergent laparoscopic appendectomy with a left lateral tilt of 70–90°. The gestational age at the time of surgery ranged from 20 to 35 weeks. The time to complete the first trocar for the camera ranged from 3 to 6 min, the operation time ranged from 30 to 60 min, and the length of hospital stay was 2–8 days. There were 5 procedures performed in the 3rd trimester. None of the cases required conversion to an open procedure, and all were without postoperative complications. Only one miscarriage complication was reported among a total of 4 patients with peritonitis. Conclusion: Our results demonstrated that urgent laparoscopic surgeries are feasible and can be safely performed with minimal risk for patients and foetuses in the second and third trimesters of pregnancy. Larger prospective studies are required to validate these findings. Highlights

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Challenging Obstetrical Management in Generalized Peritonitis during Pregnancy

Oliveira

Sousa

Martins

2022

Case Reports in Obstetrics and Gynecology

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Acute abdomen in pregnancy represents a diagnostic and therapeutic challenge, despite the current advances in modern medicine, since the typical symptoms and altered laboratory parameters mimic normal pregnancy. Acute appendicitis is the most common nonobstetric surgical emergency during pregnancy, with an incidence of 1 per 500-2000 pregnancies. Delayed diagnosis and reluctance to operate on a pregnant woman predispose to adverse maternal and fetal outcomes. The elective termination of pregnancy or interventions to prolong it in the presence of appendicitis is controversial. We present a case of a 38-year-old Caucasian woman, G2P0, admitted to the Obstetric Emergency Department at 13 4/7 weeks of gestation with a primary complaint of severe nausea and vomiting associated with progressive diffuse abdominal pain which had started 7 days before. After the difficulty of inherent differential diagnosis, she was diagnosed with generalized peritonitis due to acute perforated appendicitis. Prompt exploratory laparotomy with appendectomy and drainage of multiple abscesses were performed. Conservative obstetrical management was assumed, with subsequent periodic monitoring of the fetal focus. Due to abdominal compartment syndrome, the abdomen was left open for 4 days. After 7 days in the intensive care unit, recovery was favorable, pregnancy remained uneventful, and a healthy full-term baby was born 27 weeks later. This case represents a successful example of how the cooperation of the obstetrics and general surgery teams and the decision of conservative obstetrical management in the surgical environment contributed to optimizing maternal health, achieving the best obstetrical outcome.

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Reduced-port laparoscopic appendectomy for acute appendicitis in pregnancy

Cited by 3 publications

References 10 publications

Revisión de los protocolos sobre abdomen agudo quirúrgico no obstétrico en el embarazo.

Revisión de los protocolos sobre abdomen agudo quirúrgico no obstétrico en el embarazo.

Laparoscopic appendectomy with left lateral tilt in pregnant women in the second and third trimesters: A clinical case series in a single Vietnam centre

Challenging Obstetrical Management in Generalized Peritonitis during Pregnancy

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