Laparoscopic appendectomy vs open appendectomy during pregnancy: a systematic re-view.

IF 0.3 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Hippokratia Pub Date : 2022-01-01
A Rountis, D Dimitroulis, N Nikiteas
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引用次数: 0

Abstract

Background: Acute appendicitis and cholecystitis during pregnancy are the most common non-obstetrical surgical emergencies and can create severe clinical issues. Surgical treatment tends to be the method physicians recommend due to its tolerability and safety. During pregnancy, surgical intervention should minimize fetal risk without compromising the mother's health, although a favorable outcome for pregnant women is heavily dependent on accurate, early diagnosis and prompt intervention. Furthermore, the physicians should remain informed on the differences in current techniques to optimize the outcome of the operation.

Methods: This article performs a systematic review of the literature to examine whether laparoscopic treatment of acute appendicitis in pregnancy is a better option when compared to open surgery. We searched all major medical databases, identified the most relevant published studies on the subject, and performed a statistical analysis to answer that question.

Results: We identified 15 studies for inclusion, and their data were extracted. The resulting pool referred to 2,837 pregnant patients. Of those included patients, 1,103 underwent laparoscopic surgery and 1,656 had open surgery. All surgeries occurred in the second trimester. For laparoscopic surgery, the fetal demises rate was 2.44 % (27 deaths), and the preterm deliveries rate was 9.79 % (108 deliveries) as opposed to open surgery with a fetal demise rate of 2.64 % (48 deaths), and preterm deliveries rate at 10.7 % (178 deliveries).

Conclusions: Our meta-analysis and data suggest that laparoscopic appendectomy is a safer option for treatment. There is a reduced risk of fetal demise and preterm delivery for pregnant women. HIPPOKRATIA 2022, 26 (1):1-6.

Abstract Image

Abstract Image

腹腔镜阑尾切除术与妊娠期开放性阑尾切除术:系统回顾。
背景:妊娠期急性阑尾炎和胆囊炎是最常见的非产科手术紧急情况,可能会造成严重的临床问题。由于其耐受性和安全性,手术治疗往往是医生推荐的方法。在怀孕期间,手术干预应在不损害母亲健康的情况下将胎儿风险降至最低,尽管对孕妇的有利结果在很大程度上取决于准确、早期诊断和及时干预。此外,医生应随时了解当前技术的差异,以优化手术结果。方法:本文对文献进行了系统回顾,以检查与开放手术相比,腹腔镜治疗妊娠期急性阑尾炎是否是更好的选择。我们搜索了所有主要的医学数据库,确定了最相关的已发表研究,并进行了统计分析来回答这个问题。结果:我们确定了15项纳入研究,并提取了它们的数据。由此产生的人才库涉及2837名孕妇。在纳入的患者中,1103人接受了腹腔镜手术,1656人接受了开放手术。所有手术都发生在妊娠中期。腹腔镜手术的胎儿死亡率为2.44%(27例死亡),早产率为9.79%(108例分娩),而开放手术的胎儿死亡率为2.64%(48例死亡)和早产率为10.7%(178例分娩)。结论:我们的荟萃分析和数据表明,腹腔镜阑尾切除术是一种更安全的治疗选择。孕妇的胎儿死亡和早产风险降低。海马2022,26(1):1-6。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hippokratia
Hippokratia MEDICINE, GENERAL & INTERNAL-
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Hippokratia journal is a quarterly issued, open access, peer reviewed, general medical journal, published in Thessaloniki, Greece. It is a forum for all medical specialties. The journal is published continuously since 1997, its official language is English and all submitted manuscripts undergo peer review by two independent reviewers, assigned by the Editor (double blinded review process). Hippokratia journal is managed by its Editorial Board and has an International Advisory Committee and over 500 expert Reviewers covering all medical specialties and additionally Technical Reviewers, Statisticians, Image processing Experts and a journal Secretary. The Society “Friends of Hippokratia Journal” has the financial management of both the printed and electronic edition of the journal.
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