Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Acad Med Singap. 2012 Feb;41(2):82-6.
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).
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.
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.
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.
本研究旨在通过比较由妇科腹腔镜专家进行的腹腔镜阑尾切除术（LA）和由普通外科医生进行的开腹阑尾切除术（OA）的手术和产科结局，来探讨妊娠期间腹腔镜阑尾切除术的临床疗效和安全性。
在这项回顾性研究中，我们评估了 2000 年 1 月至 2010 年 12 月期间因急性阑尾炎在妊娠期间接受阑尾切除术的所有连续患者。28 例患者接受 OA，15 例接受 LA。我们查阅了每位患者的临床病历并分析了数据，包括年龄、产次、体重指数、阑尾切除术时的妊娠周数、阑尾切除术类型、手术时间、血红蛋白变化、住院时间、组织病理学结果、术后镇痛、并发症和产科结局。
OA 组和 LA 组在临床特征、住院时间、血红蛋白变化、肠蠕动恢复、并发症发生率、分娩时的妊娠周数和出生体重方面无显著差异。然而，LA 组的手术时间明显更短，术后镇痛药的使用量也更少。
由妇科专家进行的 LA 是治疗妊娠头三个月和第二个三个月急性阑尾炎的一种安全有效的方法。
