Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Graduate School of Medicine of Dongguk University, 27, Dongguk-ro, Ilsandong-gu, Goyang, Gyeonggi-do, 10326, Republic of Korea.
Surg Endosc. 2018 Jun;32(6):2643-2649. doi: 10.1007/s00464-018-6189-x. Epub 2018 Apr 13.
Nonobstetric surgical interventions are required in some women during pregnancy. The most common nonobstetric conditions requiring surgery during pregnancy are acute appendicitis and cholecystitis. This study aimed to evaluate pregnancy outcomes and complications following surgical procedures for presumed nonobstetric surgical interventions during pregnancy, and to compare the outcomes between the laparoscopic and open approaches.
We conducted a retrospective study of patients who underwent laparoscopic or open surgery during pregnancy for nonobstetric surgical indications at our institution between 2008 and 2016.
A total of 62 consecutive patients who underwent surgical intervention due to nonobstetric causes during pregnancy were included in our study. Of these, 35 (56.5%) were managed with laparoscopy and 27 (43.5%) with the open approach. Patients who underwent laparoscopy had a significantly shorter hospital stay and lower pain score on postoperative day 2 than those who underwent open surgery (5.5 vs. 7.2 days, p = 0.03 and 1.4 vs. 2.4, p < 0.01, respectively). There were no significant differences in operative complications between both groups. In advanced pregnancy (gestational age ≥ 23 weeks), 7 patients (41.2%) were managed with laparoscopy and 10 (58.8%) with the open approach. No differences in surgical complications were found between both groups in advanced pregnancy as well.
In our study, laparoscopic surgery was found to be feasible and safe in the late second and third trimesters as well as in the first and early second trimesters without adverse effects on pregnancy.
在某些孕妇中需要进行非产科手术干预。最常见的需要在怀孕期间进行手术的非产科情况是急性阑尾炎和胆囊炎。本研究旨在评估妊娠结局和并发症，对妊娠期间疑似非产科手术干预进行手术治疗，并比较腹腔镜和开放手术的结局。
我们对 2008 年至 2016 年期间在我院因非产科手术指征接受腹腔镜或开放手术的患者进行了回顾性研究。
本研究共纳入 62 例因非产科原因在妊娠期间接受手术干预的连续患者。其中 35 例（56.5%）采用腹腔镜治疗，27 例（43.5%）采用开放手术。与开放手术相比，腹腔镜组患者的住院时间明显更短，术后第 2 天的疼痛评分也更低（5.5 天比 7.2 天，p=0.03 和 1.4 分比 2.4 分，p<0.01）。两组手术并发症无显著差异。在妊娠晚期（孕龄≥23 周），7 例（41.2%）采用腹腔镜治疗，10 例（58.8%）采用开放手术。在妊娠晚期，两组之间也没有发现手术并发症的差异。
在我们的研究中，腹腔镜手术在妊娠晚期、妊娠中期和妊娠早期也是可行且安全的，且不会对妊娠产生不良影响。
