A Multicenter Collaborative Study on the Safety and Efficacy of Laparoscopic Appendectomy During Pregnancy

Acute appendicitis in pregnant women requires accurate diagnosis and treatment because of potential pregnancy complications. Laparoscopic appendectomy (LA) has been associated with higher rates of fetal loss than open appendectomy (OA). Therefore, we conducted the first multicenter collaborative analysis in Japan to evaluate the safety and efficacy of LA during pregnancy.

We retrospectively reviewed 152 pregnant women who underwent appendectomy for acute appendicitis between 2012 and 2021 using data from the Japan Society of Laparoscopic Colorectal Surgery. The patients were divided into the OA (n = 92) and LA (n = 60) groups. The primary endpoint was fetal loss during hospitalization. Patient demographics, perioperative outcomes, pathology, and pregnancy outcomes were analyzed.

No fetal loss occurred in either group. The operative time (p = 0.485) and postoperative complications (p = 0.708) were similar between the groups. However, the hospital stay was significantly shorter in the LA group than in the OA group (p = 0.037). The OA group had a higher rate of gangrenous or perforated appendicitis (p = 0.017).

LA is a safe alternative to OA in pregnant women, with no additional maternal complications and comparable fetal outcomes. LA does not negatively affect fetal health.