Laparoscopic appendectomy in pregnancy.
BACKGROUND
Laparoscopic appendectomy (LA) is a safe, effective, and beneficial procedure for the treatment of acute appendicitis. However, limited data are available regarding the safety and feasibility of LA during pregnancy.


METHODS
Between January 2001 and August 2004, 1235 patients with clinically suspected appendicitis underwent laparoscopic surgery at our hospital. Eleven patients (0.9%) were pregnant women (mean age, 25 years; age range, 19-37 years; range of gestational age, 4-30 weeks). Clinical data collected retrospectively included demographic information; preoperative, procedural, and postoperative information; and outcome of the pregnancy.


RESULTS
All 11 pregnant women underwent laparoscopic surgery without need of conversion. Ten patients underwent LA and were found to have acute appendicitis on histologic analysis. One patient had torsion of the right fallopian tube and a healthy-looking appendix; she underwent detorsion of the fallopian tube and incidental appendectomy. Mean operative time was 50.5 minutes (range, 20-135 minutes). Length of postoperative hospital stay averaged 4.2 days (range, 1-11 days). One patient had a surgical wound infection, which was managed conservatively. Mean follow-up period was 14 months (range, 2-46 months). Seven pregnant women delivered healthy term infants, 2 had planned abortions, and 1 experienced fetal loss due to uterine infection and premature contractions 1 month after LA. Another patient had normal results at prenatal examination.


CONCLUSIONS
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.
Wu
Jiann-Ming
JM
Department of Surgery, Far Eastern Memorial Hospital, and Department of Surgery, National Taiwan University College of Medicine, Taipei, Taiwan.
Chen
Kuo-Hsin
KH
Lin
Heng-Fu
HF
Tseng
Li-Ming
LM
Tseng
Sheng-Hong
SH
Huang
Shih-Horng
SH
D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*