• Vol. 41 No. 2, 82–86
  • 15 February 2012

Safety and Clinical Efficacy of Laparoscopic Appendectomy for Pregnant Women with Acute Appendicitis

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ABSTRACT

Introduction: The aim of this study was to investigate the clinical efficacy and safety of laparoscopic appendectomy (LA) during pregnancy by comparing the operative and obstetric outcomes of patients who during pregnancy underwent LA performed by an expert gynaecologic laparoscopist (LA group) with those patients who underwent an open appendectomy (OA) by a general surgeon (OA group).

Materials and Methods: : In this retrospective study, we evaluated all patients consecutively who had undergone appendectomy for acute appendicitis during pregnancy from January 2000 to December 2010. Twenty-eight patients underwent OA and 15 were treated by LA. We reviewed the clinical charts and analysed the data for each patient’s age, parity, body mass index, gestational age at appendectomy, type of appendectomy, operating time, haemoglobin change, hospital stay, histopathological results, postoperative analgesics, complications, and obstetric outcomes.

Results: There were no significant differences between the OA and LA groups in terms of clinical characteristics, hospital stay, haemoglobin change, return of bowel activity, complication rates, gestational age at delivery, and birth weight. However, there were significantly shorter operating time and less usage of postoperative analgesics in LA group.

Conclusion: LA performed by an expert gynaecologist can be a safe and effective method for treating acute appendicitis during the first and second trimester of pregnancy


In non-pregnant patients, the advantages of laparoscopic appendectomy (LA) over open appendectomy (OA) are widely known and include decreased postoperative pain, a shorter hospital stay, and an earlier return to work. However, pregnant patients face several potential problems with LA: the possibility of incidental injury to the gravid uterus with a Veress needle or a trocar, direct or indirect effects on the fetus and pregnant patient of the CO2 gas used to make a pneumoperitoneum, decreased uterine blood flow caused by the pneumoperitoneum, and the securing of a laparoscopic surgical field without damage to the gravid uterus. These issues have created reluctance among surgeons to perform LA during pregnancy

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