Liu Yi-Xuan, Zhang Yang, Huang Jin-Feng, Wang Li
Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Department of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China.
Int J Gynaecol Obstet. 2017 Mar;136(3):272-279. doi: 10.1002/ijgo.12069. Epub 2016 Dec 19.
The safety of laparoscopic surgery during the second trimester of pregnancy remains a controversial subject.
To compare the safety of laparoscopic surgery and laparotomy for suspected adnexal mass during the second trimester.
Articles published in any language prior to April 31, 2016, were retrieved from PubMed, Scopus, EMBSCO, and the Cochrane Library using keywords including pregnant, adnexal mass, laparoscopy, laparotomy, pregnancy outcomes, and surgical outcomes.
Randomized and non-randomized controlled trials reporting at least one obstetric or surgical outcome were included if they compared laparoscopic surgery and laparotomy for adnexal masses during the second trimester.
Data were independently extracted by two reviewers. Homogeneous data were pooled using a fixed effects model and heterogeneous data were qualitatively analyzed.
Four comparative effectiveness studies including a total of 240 patients were identified. Laparoscopic surgery was associated with a reduced risk of post-operative adverse events (relative risk 0.20, 95% confidence interval 0.06-0.72); no difference was recorded in the risk of post-operative spontaneous abortion (P=0.26) or threatened spontaneous abortion (P=0.13).
Laparoscopic surgery could be preferable to laparotomy for suspected adnexal mass during the second trimester of pregnancy.
妊娠中期腹腔镜手术的安全性仍是一个有争议的话题。
比较妊娠中期腹腔镜手术和开腹手术治疗可疑附件包块的安全性。
使用包括“怀孕”“附件包块”“腹腔镜检查”“开腹手术”“妊娠结局”和“手术结局”等关键词，从PubMed、Scopus、EMBSCO和Cochrane图书馆检索2016年4月31日前以任何语言发表的文章。
纳入比较妊娠中期腹腔镜手术和开腹手术治疗附件包块且报告至少一项产科或手术结局的随机和非随机对照试验。
由两名审阅者独立提取数据。同质数据采用固定效应模型合并，异质数据进行定性分析。
共确定了四项比较有效性研究，包括240例患者。腹腔镜手术与术后不良事件风险降低相关（相对风险0.20，95%置信区间0.06 - 0.72）；术后自然流产风险（P = 0.26）或先兆自然流产风险（P = 0.13）无差异。
妊娠中期腹腔镜手术治疗可疑附件包块可能优于开腹手术。
