妊娠期阑尾切除术后早产的风险在阑尾切除术阴性的情况下更高。

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-02-01 Epub Date: 2024-11-28 DOI:10.1016/j.amjsurg.2024.116120

Yoav Baruch, Sabina Razdolsky, Emmanuel Attali, Matan Anteby, Yariv Yogev, Nadav Michaan

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引用次数: 0

摘要

背景：报道的妊娠期阑尾切除术后的结局仍然不确定，早产的风险不一定与手术有关。方法：这项回顾性队列研究包括185名在2005年至2022年期间在怀孕期间接受阑尾切除术并分娩的孕妇，以3:1的比例与555名未接受手术的孕妇进行比较。分析临床、产科和新生儿结局。结果：腹腔镜阑尾切除术是最常见的手术方式(117/185；63.2%), 68/185（36.8%）行开腹阑尾切除术。病理结果显示141/185例（76.2%）为阑尾炎，44/185例（23.8%）为“白色阑尾”（阴性阑尾）。阑尾切除术组早产发生率更高[22/185 (11.9%)vs 30/555 (5.4%), p = 0.003]，阴性阑尾切除术组的早产发生率高于炎症阑尾组[9/44 (20.5%)vs 13/141 (9.2%), p = 0.044]。多变量分析发现阑尾切除术（但不是阑尾发炎）是早产的唯一显著危险因素（优势比2.3,CI 1.26-4.15, p = 0.006）。结论：阑尾切除术阴性与早产相关。仔细评估是必要的，以避免不必要的手术干预在怀孕期间。

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The risk of preterm delivery after appendectomy during pregnancy is higher in the face of a negative appendectomy.

Background: Reported outcomes after appendectomy during pregnancy remain inconclusive, and the risk for preterm delivery is not necessarily procedure-related.

Methods: This retrospective cohort study included 185 pregnant women who underwent appendectomy during pregnancy and gave birth between 2005 and 2022, compared using a 3:1 ratio to 555 parturients who did not undergo surgery. clinical, obstetrical and neonatal outcomes were analyzed.

Results: Laparoscopic appendectomy was the most common procedure (117/185; 63.2 %) whereas 68/185 (36.8 %) had open appendectomy. Pathological findings revealed that 141/185 cases (76.2 %) had an inflamed appendix, while 44/185 (23.8 %) were classified as having a "white appendix" (negative appendectomy). Preterm delivery occurred more frequently in the appendectomy group [22/185 (11.9 %) vs 30/555 (5.4 %), p = 0.003] with even higher incidence in negative appendectomies compared to inflamed appendix cases [9/44 (20.5 %) vs 13/141 (9.2 %), p = 0.044]. Multivariate analysis identified appendectomy (but not an inflamed appendix) as the sole significant risk factor for preterm birth (odds ratio 2.3, CI 1.26-4.15, p = 0.006).

Conclusion: Preterm delivery correlates with negative appendectomies. Careful assessment is essential to avoid unnecessary surgical interventions during pregnancy.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.