Maternal and Fetal Outcomes After Laparoscopic Vs. Open Appendectomy in Pregnant Women: Data From Two Tertiary Referral Centers

Abstract

Objectives: Appendectomy is the most common cause of non-obstetric surgery in pregnant women. Our aim was to compare the clinical characteristics, pert-and post-operative data of pregnant women undergoing either laparoscopic appendectomy (LA) or open appendectomy (OA). Material and methods: This was a retrospective study of medical records of all pregnant women diagnosed and treated surgically for acute appendicitis at two referral centers of Yuzuncu Yil University Medical Faculty and Kafkas University Medical Faculty, from January 2010 to January 2015. Results: The study included 48 patients, divided to two groups (12 - LA and 36 - OA). There were no significant differences in demographic characteristics of the studied population, including age, BMI, gestational age at operation, gravidity, parity, and history of cesarean sections. A far as obstetric and fetal outcomes are concerned, no significant differences were found in terms of preterm delivery, fetal loss, delivery mode, birth weight, APGAR score, and maternal death between the two investigated groups. One perioperative complication of intra-abdominal abscess was noted in the OA group. However, the LA group had shorter hospital stay (3.25 +/- 2.45 vs. 4.28 +/- 3.31, p=0.004), earlier mobilization time (8.1 +/- 2.2 vs. 10.1 +/- 1.6, p=0.025), and shorter time to first flatus (2.3 +/- 0.3 vs. 4.0 +/- 1.6, p=0.032) as compared to the OA group. The OA group had statistically shorter operation time than the LA group (38.61 +/- 11.5 vs. 49.42 +/- 11.38, p=0.007). Conclusion: LA is related to shorter hospital stay, faster return to daily activities, and shorter time to first flatus. LA appears to be as safe and effective as OA in pregnant patients without increasing adverse perinatal outcomes.