Appendectomy in Pregnancy: Appraisal of the Minimally Invasive Approach.
BACKGROUND
The optimal surgical approach to acute appendicitis in pregnancy remains controversial. Our aim was to compare perioperative and obstetric outcomes associated with laparoscopic and open appendectomy in a large contemporary cohort of pregnant women.


METHODS
Retrospective review of all women who underwent appendectomy during pregnancy in a single hospital during 2000-2014.


RESULTS
Ninety-two patients met the study criteria. Fifty (54%) underwent laparoscopic appendectomy and 42 (46%) open appendectomy. The laparoscopy group had a lower median gestational age at surgery (16 weeks versus 24 weeks, P < .001), a shorter median hospital stay (5 days versus 3 days, P < .001), and a lower rate of postoperative complications (8% versus 24%, P = .04). There were no significant between-group differences in the rates of gestational age at delivery, Apgar scores, preterm delivery, and fetal loss.


CONCLUSIONS
Laparoscopic appendectomy during pregnancy is safe and associated with better surgical outcomes than open appendectomy, with no difference in obstetric outcomes.
1 Department of General and Oncological Surgery-Surgery C, Sheba Medical Center , Ramat Gan, Israel .|2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
Lior
L
Segev
3 Department of Obstetrics and Gynecology, Carmel Medical Center , Haifa, Israel .|4 Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology , Haifa, Israel .
Yakir
Y
Segev
1 Department of General and Oncological Surgery-Surgery C, Sheba Medical Center , Ramat Gan, Israel .|2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
Shlomi
S
Rayman
1 Department of General and Oncological Surgery-Surgery C, Sheba Medical Center , Ramat Gan, Israel .|2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
Ron
R
Shapiro
1 Department of General and Oncological Surgery-Surgery C, Sheba Medical Center , Ramat Gan, Israel .|2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
Aviram
A
Nissan
2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .|5 Department of Surgery B, Rabin Medical Center , Petah Tikva, Israel .
Eran
E
Sadot
D000208:Acute Disease; D000328:Adult; D001034:Apgar Score; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
appendectomy; laparoscopy; pregnancy