Yoo Kwon Cheol, Park Jun Ho, Pak Kyung Ho, Kim Kwang Yong, Lee Bong Hwa, Kim Byung Chun, Kim Jong Wan
Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40, Sukwoo-Dong, Hwaseong-Si, Gyeonggi-Do, 445-170, Republic of Korea.
Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445 Gil-1-dong, Gangdong-gu, Seoul, 134-701, Republic of Korea.
Int J Colorectal Dis. 2016 Aug;31(8):1475-81. doi: 10.1007/s00384-016-2584-8. Epub 2016 Apr 12.
The purpose of this study was to compare the perioperative and obstetric outcomes of pregnant women between laparoscopic surgery and open surgery and to evaluate the predictive factors for overall obstetric outcomes.
We retrospectively reviewed the medical records of pregnant women who underwent appendectomy between January 2008 and June 2015 at six hospitals affiliated to Hallym University.
Eighty patients were evaluated. Twenty-four underwent laparoscopic appendectomy (LA) and 56 underwent open appendectomy (OA). There were no significant differences in the patients' characteristics and gestational age at surgery between the two groups. Operation time, time to flatus, and time to soft food intake were similar in both groups. The length of stay was shorter in the LA group than in the OA group (5.1 vs 8.1 days, P = 0.044). Gestational age at delivery, birth weight, and delivery type were similar in both groups. There was no significant difference in overall obstetric poor outcome (20.8 vs 14.3 %, P = 0.516), including preterm delivery (8.3 vs 7.1 %, P = 1.000) and fetal loss (12.5 vs 7.1 %, P = 0.350). Multivariable analysis revealed that fever >38 °C (P = 0.022) and maternal age (P = 0.044) were independent predictors for the overall poor outcomes.
LA was associated with shorter length of stay compared with OA, but perioperative and obstetric outcomes were similar with both procedures. LA can be safely performed in pregnant women in any trimester.
本研究旨在比较腹腔镜手术和开放手术的孕妇围手术期及产科结局，并评估总体产科结局的预测因素。
我们回顾性分析了2008年1月至2015年6月在翰林大学附属的六家医院接受阑尾切除术的孕妇的病历。
共评估了80例患者。24例行腹腔镜阑尾切除术（LA），56例行开放阑尾切除术（OA）。两组患者的特征及手术时的孕周无显著差异。两组的手术时间、排气时间和开始进食软食的时间相似。LA组的住院时间比OA组短（5.1天对8.1天，P = 0.044）。两组的分娩孕周、出生体重和分娩方式相似。总体产科不良结局（20.8%对14.3%，P = 0.516），包括早产（8.3%对7.1%，P = 1.000）和胎儿丢失（12.5%对7.1%，P = 0.350）无显著差异。多变量分析显示，体温>38°C（P = 0.022）和产妇年龄（P = 0.044）是总体不良结局的独立预测因素。
与OA相比，LA的住院时间更短，但两种手术的围手术期及产科结局相似。LA可在任何孕周的孕妇中安全进行。
