Weiner Eran, Mizrachi Yossi, Keidar Ran, Kerner Ram, Golan Abraham, Sagiv Ron
Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Halochamim St. 62, Holon, Israel.
Arch Gynecol Obstet. 2015 Nov;292(5):1063-8. doi: 10.1007/s00404-015-3744-8. Epub 2015 May 10.
The aim of our study was to assess the clinical and obstetric outcomes of laparoscopic surgeries performed during advanced pregnancy compared to those performed in early pregnancy.
We retrospectively reviewed all cases of patients who underwent laparoscopic surgery during pregnancy in our institution between 1996 and 2013.
We reviewed cases of 117 pregnant women who underwent laparoscopic surgery during the study period. There were no conversions to laparotomy. 71 surgeries were performed in the first trimester (group 1, mean gestational age 7.7 ± 1.9 weeks) and 46 were performed in the second and third trimesters (group 2, mean gestational age 18.1 ± 4.3 weeks). More patients in group 1 underwent surgery for suspected adnexal torsion (p < 0.001), while more patients in group 2 underwent surgery for presumptive cholecystitis (p = 0.014) and persistent ovarian mass (p = 0.011). The interval between admission and surgery differed significantly between the groups and was longer in group 2 compared to group 1 (18.2 ± 24.0 vs. 6.8 ± 10.6 h, p = 0.001). No difference was found between the two groups regarding surgical complications, histopathological findings and pregnancy outcomes.
In our experience, laparoscopic surgery in advanced pregnancy was found to be feasible and safe as in early pregnancy, without any adverse effects on pregnancy outcome.
我们研究的目的是评估晚期妊娠期间进行的腹腔镜手术与早期妊娠期间进行的腹腔镜手术相比的临床和产科结局。
我们回顾性分析了1996年至2013年在我们机构接受妊娠期间腹腔镜手术的所有患者病例。
我们回顾了研究期间117例接受腹腔镜手术的孕妇病例。无一例转为开腹手术。71例手术在孕早期进行（第1组，平均孕周7.7±1.9周），46例在孕中期和孕晚期进行（第2组，平均孕周18.1±4.3周）。第1组更多患者因疑似附件扭转接受手术（p<0.001），而第2组更多患者因推定胆囊炎（p=0.014）和持续性卵巢肿块（p=0.011）接受手术。两组入院与手术之间的间隔时间差异显著，第2组比第1组长（18.2±24.0 vs. 6.8±10.6小时，p=0.001）。两组在手术并发症、组织病理学结果和妊娠结局方面未发现差异。
根据我们的经验，晚期妊娠腹腔镜手术与早期妊娠一样可行且安全，对妊娠结局无任何不良影响。
