Palanivelu Chinnusamy, Rangarajan Muthukumaran, Senthilkumaran Saravanan, Parthasarathi Ramakrishnan
Gem Hospital, Coimbatore, Tamil Nadu, India.
J Laparoendosc Adv Surg Tech A. 2007 Apr;17(2):186-90. doi: 10.1089/lap.2006.0037.
We report all the procedures performed in pregnant patients in our institute. There were 2 cases of laparoscopic mesh repair (for posterolateral diaphragmatic Bochdalek hernia and laparoscopic Heller cardiomyotomy) and 1 laparoscopic cystectomy for torsion of an ovarian cyst; 7 laparoscopic appendectomies (6 for acute appendicitis and 1 for perforated appendix); and 9 laparoscopic cholecystectomies (8 for acute cholecystitis and 1 for gallbladder empyema). All these patients were in their second trimester of pregnancy. All the laparoscopic procedures were successful: there was no mortality, morbidity, or conversions. There were no complications for either mother or child related to general anesthesia. The changes in physiology of the pregnant patient have to be adequately addressed and proper precautions taken to ensure safety. The second trimester is the ideal time to do laparoscopic surgery, though procedures have been performed in all trimesters. Our initial experience is satisfactory, although more data are essential to standardize laparoscopic procedures in pregnancy. We conclude that laparoscopic surgery is proving to be as safe as open surgery in pregnancy.
我们报告了我院对孕妇实施的所有手术。其中有2例腹腔镜补片修补术（用于后外侧膈肌Bochdalek疝和腹腔镜Heller贲门肌切开术）以及1例腹腔镜卵巢囊肿扭转切除术；7例腹腔镜阑尾切除术（6例为急性阑尾炎，1例为阑尾穿孔）；还有9例腹腔镜胆囊切除术（8例为急性胆囊炎，1例为胆囊积脓）。所有这些患者均处于妊娠中期。所有腹腔镜手术均获成功：无死亡、并发症或中转开腹情况。未出现与全身麻醉相关的母婴并发症。必须充分考虑妊娠患者生理上的变化并采取适当预防措施以确保安全。妊娠中期是进行腹腔镜手术的理想时期，不过在所有孕期都有实施过此类手术。我们的初步经验令人满意，尽管需要更多数据才能使妊娠期腹腔镜手术标准化。我们得出结论，事实证明腹腔镜手术在妊娠期与开腹手术一样安全。
