Carter James F, Soper David E
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston 29425, USA.
JSLS. 2004 Jan-Mar;8(1):57-60.
We compared the surgical outcomes of pregnant women undergoing laparotomy in the first 2 trimesters of pregnancy with those undergoing laparoscopy for the management of acute pelvic pain.
We performed a systematic retrospective chart review of patients whose discharge diagnosis included intrauterine pregnancy with exploratory laparotomy or laparoscopy from August 1, 1993 to October 31, 1999. The following factors were assessed: preoperative diagnosis, postoperative diagnosis, gestational age at the time of surgery, operative time, hospital stay, pathology, gestational age at delivery, complications, and outcome of the pregnancy in both groups.
Sixteen pregnant patients underwent surgery during the study period. All but one had abdominopelvic pain, and all patients had an associated adnexal mass. The mean gestation age at the time of surgery was 15+/-6 weeks versus 13+/-4 weeks in the laparoscopic and laparotomy groups, respectively (P=NS). All patients undergoing laparoscopy remained in the hospital for one day compared with a mean of 4.4+/-1.1 days in the laparotomy group (P<0.0001). Pregnancy outcomes were similar and uniformly good.
Laparotomy can be avoided and pregnant patients managed safely by operative laparoscopy, with shorter hospital stays.
我们比较了妊娠前2个孕季接受剖腹手术的孕妇与接受腹腔镜检查以处理急性盆腔疼痛的孕妇的手术结果。
我们对1993年8月1日至1999年10月31日出院诊断包括宫内妊娠并接受探查性剖腹手术或腹腔镜检查的患者进行了系统的回顾性病历审查。评估了以下因素：术前诊断、术后诊断、手术时的孕周、手术时间、住院时间、病理、分娩时的孕周、并发症以及两组的妊娠结局。
在研究期间，16名孕妇接受了手术。除1名外，所有患者均有腹盆腔疼痛，且所有患者均伴有附件包块。腹腔镜组和剖腹手术组手术时的平均孕周分别为15±6周和13±4周（P=无显著性差异）。所有接受腹腔镜检查的患者住院1天，而剖腹手术组的平均住院时间为4.4±1.1天（P<0.0001）。妊娠结局相似且均良好。
通过手术腹腔镜检查可避免剖腹手术，且能安全地处理妊娠患者，住院时间更短。
