Iwamura Sena, Hashida Hiroki, Yoh Tomoaki, Kitano Shoichi, Mizumoto Motoko, Kitamura Koji, Kondo Masato, Kobayashi Hiroyuki, Kaihara Satoshi, Hosotani Ryo
Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Asian J Endosc Surg. 2018 Nov;11(4):413-416. doi: 10.1111/ases.12456. Epub 2018 Jan 4.
Acute appendicitis is the most common general surgical problem encountered during pregnancy. Laparoscopic appendectomy (LA) is widely accepted as a minimally invasive procedure for acute appendicitis. However, LA during the third trimester is associated with problems, including technical difficulty, risk of preterm delivery, and fetal loss. We successfully managed three cases of LA during the third trimester between 2011 and 2016. None of the cases required conversion to an open procedure, and none of the patients had postoperative complications and/or fetal loss. We reviewed the literature using the PubMED database from 2007 to 2016 to acquire further evidence and identified 6 reports and 17 cases. The conversion rate was 11.8% (2 cases), the complication rate was 6.67% (1 case), and the preterm delivery rate was 20% (3 cases); no fetal loss was observed. Our study and literature review highlights the role of LA as a potentially feasible treatment approach for appendicitis during the third trimester.
急性阑尾炎是孕期最常见的普通外科问题。腹腔镜阑尾切除术（LA）作为急性阑尾炎的微创手术方法已被广泛接受。然而，孕晚期行LA存在一些问题，包括技术难度、早产风险和胎儿丢失。我们在2011年至2016年间成功处理了3例孕晚期LA病例。无一例需要转为开腹手术，且所有患者均无术后并发症和/或胎儿丢失。我们使用2007年至2016年的PubMED数据库回顾文献以获取更多证据，共识别出6篇报告和17例病例。中转率为11.8%（2例），并发症发生率为6.67%（1例），早产率为20%（3例）；未观察到胎儿丢失。我们的研究和文献回顾凸显了LA作为孕晚期阑尾炎潜在可行治疗方法的作用。
