Appendectomy during pregnancy--is pregnancy outcome depending by operation technique?

Area of Science:

• Obstetrics and Gynecology
• Surgical Gastroenterology
• Maternal-Fetal Medicine

Background:

• Acute appendicitis is a common surgical emergency during pregnancy.
• Appendectomy is the standard treatment, but surgical approach (laparoscopic vs. open) requires careful consideration due to pregnancy.
• Limited data exists comparing outcomes of different appendectomy techniques in pregnant patients.

Purpose of the Study:

• To compare perioperative and pregnancy outcomes between laparoscopic and open appendectomy in pregnant women with presumed acute appendicitis.

Main Methods:

• Retrospective cohort study.
• Inclusion of all women undergoing appendectomy during pregnancy (2000-2009) at a tertiary referral center.
• Comparison of outcomes between laparoscopic appendectomy (LA) and open appendectomy (OA) groups.

Main Results:

• 85 pregnant women underwent appendectomy; 26 LA and 59 OA.
• No significant differences in general, delivery, or neonatal outcomes between groups.
• Laparoscopic appendectomy group had significantly earlier gestational age at surgery (14.6 vs. 19.3 weeks) and lower post-operative complication rates (3.8% vs. 25.5%) compared to open appendectomy.

Conclusions:

• Laparoscopic appendectomy is a safe and effective surgical option for acute appendicitis during pregnancy.
• LA is associated with significantly fewer post-operative complications compared to OA in pregnant patients.
• LA may be preferred due to reduced complication rates and potentially earlier surgical intervention.