Systematic review and meta-analysis of safety of laparoscopic<i>versus</i>open appendicectomy for suspected appendicitis in pregnancy

Wilasrusmee, Chumpon; Sukrat, Bunyarit; McEvoy, Mark; Attia, John; Thakkinstian, Ammarin

doi:10.1002/bjs.8889

Cited by 158 publications

(114 citation statements)

References 45 publications

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“…The fetal death rate in non complicated appendicitis has been reported at 1.5 to 4%, but in cases of perforated appendicitis, the rate is still high at 21 to 35% [14]. In our study, open appendectomy was preferred to laparoscopic approach since it is associated with a lower rate of fetal loss as evidenced in previous two systematic reviews and meta-analysis [15,16]. Our study was conducted to detect predictors of fetal loss other than complicated appendicitis, the use of general anesthesia, operative time greater than 60 minutes; midline incision, postoperative pneumonia and hospital stay more than 3 days were found to be strong predictors of fetal loss.…”

Section: Discussionsupporting

confidence: 50%

Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study

Masood

Saleh

Shaheen

et al. 2016

OGIJ

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Objective: To assess the maternal and fetal outcome in pregnant women presented with acute appendicitis and to detect predictors of fetal loss. Methods:A prospective observational study included 118 pregnant women presented with acute appendicitis and divided into two groups, uncomplicated appendicitis group (n=64) and complicated appendicitis group (n=54). Operative details, maternal and fetal outcome were assessed. Univariate and multivariate analyses were used to detect predictors of fetal loss. Data was collected and tabulated.Results: Patients in the complicated group have gone midline incision, longer operative time, more postoperative fever, more surgical site infection, longer hospital stay (p<0.001), higher rate of abortion and fetal demise (p<0.05) than uncomplicated appendicitis patients. Conclusion:Poorer obstetric outcome was encountered in complicated cases. In addition to complicated appendicitis, the use of general anesthesia, operative time greater than 60 minutes, midline incision, postoperative pneumonia and hospital stay more than 3 days were other predictors of fetal loss. Larger studies are warranted to confirm or refute our findings.

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Section: Discussionsupporting

confidence: 50%

Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study

Masood

Saleh

Shaheen

et al. 2016

OGIJ

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“…Systematic review by Walsh et al (2008) found significantly high foetal loss (6 %) but lower preterm delivery rate [15]. Systematic review and meta-analysis by Wilasrusmee et al (2012) [17].…”

Section: Appendicitismentioning

confidence: 95%

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and lowrisk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.

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“…Several systematic reviews and meta-analyses showed higher rates of fetal loss with laparoscopy as compared to open appendectomy, with the rate of fetal loss with laparoscopy approximately 5.6% versus 3.1% with open appendectomy [50, [90][91][92][93]. However, there was no difference in length of hospitalization, wound infection rate or APGAR scores between the two surgical techniques [93].…”

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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Systematic review and meta-analysis of safety of laparoscopicversusopen appendicectomy for suspected appendicitis in pregnancy

Cited by 158 publications

References 45 publications

Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study

Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

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

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