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妊娠期腹腔镜与开腹阑尾切除术:单中心经验

Laparoscopic versus open appendectomy in pregnancy: A single center experience.

作者信息

Gök Ali Fuat Kaan, Soydaş Yiğit, Bayraktar Adem, Emirikçi Selman, İlhan Mehmet, Koltka Ahmet Kemalettin, Günay Mustafa Kayıhan

机构信息

Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2018 Nov;24(6):552-556. doi: 10.5505/tjtes.2018.26357.

DOI:10.5505/tjtes.2018.26357
PMID:30516255
Abstract

BACKGROUND

The aim of this study was to compare the obstetric and surgical outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) performed for pregnant women at a single center. It was the hypothesis of this study that there would be no significant difference in the results.

METHODS

The medical records of 57 consecutive pregnant women who underwent an appendectomy between January 2009 and September 2018 were reviewed retrospectively. The patients were divided into 2 groups: OA and LA. The collected data included age, gestational age, diagnostic modalities used, duration of surgery, length of hospital stay, morbidity, and mortality.

RESULTS

Eighteen (31%) patients underwent LA and 39 (69%) patients underwent OA. There were no significant differences in the demographic data. The duration of surgery was significantly less in the laparoscopic group (37 vs 57 minutes; p=0.005). There were no statistically significant differences in the outcomes of deep or superficial surgical site infection, length of hospital stay, pre-term delivery, or loss of the fetus. There was no mortality in either group.

CONCLUSION

The results of this study suggest that LA can be a safe option for both the pregnant patient and the child. Further prospective, randomized studies with a larger group of pregnant patients with appendicitis are needed to fully determine the effects of laparoscopy in these circumstances.

摘要

背景

本研究旨在比较在单一中心对孕妇进行腹腔镜阑尾切除术(LA)和开腹阑尾切除术(OA)的产科及手术结局。本研究的假设是结果不会有显著差异。

方法

回顾性分析2009年1月至2018年9月期间连续57例行阑尾切除术的孕妇的病历。患者分为两组:OA组和LA组。收集的数据包括年龄、孕周、所用诊断方式、手术时长、住院时间、发病率和死亡率。

结果

18例(31%)患者接受了LA,39例(69%)患者接受了OA。人口统计学数据无显著差异。腹腔镜组的手术时长显著更短(37分钟对57分钟;p=0.005)。深部或浅部手术部位感染、住院时间、早产或胎儿丢失的结局无统计学显著差异。两组均无死亡病例。

结论

本研究结果表明,LA对孕妇及其胎儿而言可能是一种安全的选择。需要进一步开展针对更多阑尾炎孕妇群体的前瞻性随机研究,以全面确定腹腔镜检查在这些情况下的效果。

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