Laparoscopic appendectomy during pregnancy: between personal experiences and scientific evidence.
BACKGROUND
Although laparoscopic appendectomy is a safe and effective procedure for management of acute appendicitis, data about the feasibility and safety during pregnancy are limited. We aimed to study our experience in this field and to review the scientific evidence available.


METHODS
All patients undergoing laparoscopic appendectomy during pregnancy, from January 2003 to December 2005, were included. Medical files were reviewed retrospectively. In addition, 133 cases from the literature were reviewed. General features of the cases, surgical technique details, and outcomes were analyzed.


RESULTS
All laparoscopic procedures were completed without conversion to open operation. No substantial hemodynamic or gasometric changes were detected during the procedures. Tocolytic medication was not administered in any patient. All patients were discharged from hospital within the first 48 postoperative hours, and no complications were recorded during this period or in the followup. All newborns had an adequate weight for gestational age, satisfactory parameters of well-being at birth, and an uneventful development after 1-year followup.


CONCLUSIONS
Laparoscopic appendectomy during pregnancy is as effective and safe as the conventional approach and has all the benefits of minimally invasive operation, provided that specific recommendations for these types of patients are strictly followed. It must be mentioned that there is only limited scientific evidence to support this statement.
Moreno-Sanz
Carlos
C
Department of General Surgery, La Mancha-Centro General Hospital, Alcazar de San Juan, Ciudad Real, Spain. cmsurgery@hotmail.com
Pascual-Pedreño
Ana
A
Picazo-Yeste
Joaquin S
JS
Seoane-Gonzalez
Jose B
JB
D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome