Barnes Stephen L, Shane Matthew D, Schoemann Mark B, Bernard Andrew C, Boulanger Bernard R
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536-0293, USA.
Am Surg. 2004 Aug;70(8):733-6.
Appendicitis and pregnancy are both common conditions, and when they co-exist, both the general surgeon and obstetrician are presented with unique challenges. Acute appendicitis is the most common cause of the acute abdomen during pregnancy, effecting 0.1-0.3 per cent of pregnancies each year. With an estimated 4 million deliveries per year in the United States, there are potentially as many as 12,000 cases of acute appendicitis to be managed by the general surgeon during pregnancy (Eur J Surg 1992;158:603-6; Curr Surg 2003;60:164-73). Laparoscopic appendectomy has become a routine procedure and is now widely performed in North America. Although laparoscopic appendectomy has been discussed during pregnancy, limited data is available on the role of laparoscopic appendectomy in the third trimester of pregnancy. In fact, some authors have advocated a gestational age of 26-28 weeks to be the upper gestational limit for successful completion of laparoscopic surgery (Obstet Gynecol Surg 2001;56:50-9). In this paper, we present two recent cases of successful laparoscopic appendectomy during late pregnancy without immediate complication to mother or fetus and a description of our operative technique.
阑尾炎和妊娠都是常见情况，当二者并存时，普通外科医生和产科医生都会面临独特的挑战。急性阑尾炎是孕期急腹症的最常见病因，每年影响0.1%至0.3%的妊娠。在美国，估计每年有400万例分娩，孕期普通外科医生可能要处理多达12000例急性阑尾炎病例（《欧洲外科杂志》1992年；158:603 - 6；《当代外科》2003年；60:164 - 73）。腹腔镜阑尾切除术已成为常规手术，目前在北美广泛开展。虽然孕期腹腔镜阑尾切除术已被讨论，但关于其在妊娠晚期的作用的数据有限。事实上，一些作者主张妊娠26 - 28周为成功完成腹腔镜手术的妊娠上限（《妇产科手术学》2001年；56:50 - 9）。在本文中，我们介绍两例近期妊娠晚期成功实施腹腔镜阑尾切除术且母婴均无即刻并发症的病例，并描述我们的手术技术。
