Safety of laparoscopic appendectomy during pregnancy.
BACKGROUND
Use of laparoscopic appendectomy (LA) remains controversial during pregnancy because data regarding procedure safety are limited. The outcome of LA in pregnant women was evaluated and compared to results of open surgery.


METHODS
Between January 1997 and December 2007, 42 pregnant women (mean age 24 years [range: 19-40 years]; range of gestation: 5-25 weeks) underwent appendectomy for suspected acute appendicitis: 23 laparoscopic (LA) and 19 open appendectomies (OA). Retrospective review of medical charts included preoperative information, surgery results, and outcome of the pregnancy.


RESULTS
There was no difference between groups in surgery delay following arrival at the hospital. All procedures, except one case of Meckel's diverticulitis, were completed laparoscopically without need for conversion. Acute appendicitis was found in 19 cases and Meckel's diverticulitis in one case during LA (87%) and in 18 cases (95%) during OA. Complicated appendicitis was found in 7 (30%) pregnant women in the LA group and 1 (5%) in the OA group. Five women with normal preoperative abdominal ultrasonography had acute appendicitis (2 in the OA group and 3 in the LA group). The laparoscopic procedure was performed more often by senior surgeons (70% of cases), and OA was more commonly done by residents (47% of cases). There were no intraoperative or postoperative complications recorded. The length of postoperative hospital stay was slightly prolonged after LA-2.4 days versus 1.4 day after OA. There was one fetal loss in each group, 1 and 2 months after the operation.


CONCLUSIONS
Laparoscopic appendectomy is safe and effective during pregnancy and is associated with good maternal and fetal outcome.
Kirshtein
Boris
B
Department of Surgery "A", Soroka University Medical Center, POB 151, Beer-Sheva 84101, Israel. borkirsh@bgu.ac.il
Perry
Zvi Howard
ZH
Avinoach
Eliezer
E
Mizrahi
Solly
S
Lantsberg
Leonid
L
D000208:Acute Disease; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D055815:Young Adult