Authors: Patrice Lemieux Pascal Rheaume Isabelle Levesque Emmanuel Bujold Gaetan Brochu
Publish Date: 2008/12/05
Volume: 23, Issue: 8, Pages: 1701-
Abstract
Laparoscopic surgery in pregnancy remains debated especially in cases of suspected appendicitis Cases of suspected appendicitis treated by the laparoscopic approach in a single institution over a 10year period were reviewed 1997–2007 The objectives were to evaluate the immediate complications of the procedure and the outcome of pregnancies including foetal loss and preterm deliveryRetrospective analysis of 45 consecutive cases of suspected appendicitis during pregnancy was carried out Fortytwo patients 93 had a preoperative ultrasound of which 13 33 confirmed an acute appendicitis Out of 45 cases 15 33 had the surgical procedure during the first trimester 22 49 in the second and 8 18 in the third Two 4 patients had major complications intraabdominal abscess and uterine perforation and two others 4 had minor complications cystitis and ileus No patients underwent delivery in the month following surgery and there was no foetal loss in the followup Three 81 patients delivered prior to 35 weeks’ gestation and 181 delivered before term 37 weeks As previously reported a high rate of normal appendix 33 was found at surgery No significant differences were found in rates of preterm delivery adverse outcome or operative time between trimesters of pregnancy at the time of surgery Mean operative time was 49 ± 19 minThis large series from a single institution shows a low rate of preterm delivery and absence of foetal loss after laparoscopic appendectomy Regardless of trimester the low rate of complication makes it a valuable option for pregnant patients with suspicion of acute appendicitis The rate of normal appendectomies remaining high efforts have to be made towards new diagnostic modalities to lower the negative appendectomy rate in this specific populationDr Louis Beland Dr YvesMarie Dion Dr JeanPierre Gagne Dr Roger C Gregoire Dr Jean Peloquin Dr Claude Thibault Dr Claude A Rouleau and Dr Guy Roy are acknowledged for contributing cases to the study The editorial assistance of Ovid M Da Silva is acknowledged Dr Bujold holds a ClinicianScientist Award from the Canadian Institute for Health Research and the Jeanne et JeanLouis Lévesque Chair at Laval University
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