Safety of Laparoscopic Appendectomy During Pregnancy

Kirshtein, Boris; Perry, Zvi H.; Avinoach, Eliezer; Mizrahi, Shlomo; Lantsberg, Leonid

doi:10.1007/s00268-008-9890-4

Cited by 84 publications

(71 citation statements)

References 38 publications

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“…The first described case of laparoscopic appendectomy was performed during the 8th week of pregnancy, followed thereafter with a 1990 case series of six patients averaging 16.3 weeks of gestation; each had no reported complications. Overall, when considering the effects of laparoscopic appendectomy on fetal outcomes, reported rates of fetal demise are low, ranging from 0 to 4.8 % [19,20,22,[30][31][32][33]. According to the CDC, the current rate of fetal loss surveying all pregnancies in the USA excluding elective abortions is 17 % [34].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients

et al. 2015

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show abstract

“…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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“…However, advocates of the laparoscopic approach have cited longterm studies that demonstrate its safety for the fetus and mother, independent of trimester, and relate complications to the degree of underlying severity of appendicitis [93,[95][96][97][98]. 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].…”

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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Safety of Laparoscopic Appendectomy During Pregnancy

Abstract: Laparoscopic appendectomy is safe and effective during pregnancy and is associated with good maternal and fetal outcome.

Cited by 84 publications

References 38 publications

Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients

Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients

Acute appendicitis in pregnancy: literature review

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

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