Laparoscopic appendectomy vs open appendectomy during pregnancy: a systematic re-view

Area of Science:

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

Background:

• Acute appendicitis and cholecystitis are common non-obstetrical surgical emergencies in pregnancy.
• Surgical intervention is recommended but must balance maternal health with fetal safety.
• Early diagnosis and prompt intervention are crucial for favorable outcomes in pregnant patients.

Purpose of the Study:

• To systematically review and compare laparoscopic versus open surgery for acute appendicitis in pregnant patients.
• To determine if laparoscopic appendectomy offers improved safety outcomes compared to open surgery during pregnancy.

Main Methods:

• Systematic review of major medical databases.
• Inclusion of published studies comparing laparoscopic and open appendectomy in pregnancy.
• Statistical analysis of extracted data from relevant studies.

Main Results:

• Fifteen studies involving 2,837 pregnant patients were analyzed.
• Laparoscopic surgery (1,103 patients) showed a fetal demise rate of 2.44% and preterm delivery rate of 9.79%.
• Open surgery (1,656 patients) had a fetal demise rate of 2.64% and preterm delivery rate of 10.7%.

Conclusions:

• Laparoscopic appendectomy appears to be a safer treatment option for acute appendicitis during pregnancy.
• The data suggest a reduced risk of fetal demise and preterm delivery with the laparoscopic approach.
• Optimizing surgical techniques is essential for favorable maternal and fetal outcomes.