Effectiveness of the laparoscopic appendectomy on_x000D_ second half of the pregnancy

Abstract

Aim: Although the debate regarding fetal loss and preterm delivery continues, the use of laparoscopic appendectomy (LA) to treat_x000D_ pregnant women has gained legitimacy owing to the advantages it brings, such as less uterine manipulation, less postoperative_x000D_ pain, and an early return to normal daily activity. This present study aims to compare the impact of LA on women in early and late_x000D_ gestation periods with regard to surgical outcomes._x000D_ Material and Methods: After scanning the files of 4,295 cases, 29 patients who underwent LA for acute appendicitis during pregnancy_x000D_ were enrolled in the study and were assessed retrospectively. The patients were divided into two groups: women with a gestation_x000D_ period less than 20 weeks (group 1; n=19) and those over 20 weeks (group 2; n=10). Data from these two groups, including patient_x000D_ perioperative characteristics and morbidity, were compared._x000D_ Results: The results showed no statistical difference between the two groups. No statistically significant difference was detected_x000D_ in terms of mean age, body mass index, length of hospital stay, operation time or median ASA score (p > 0.05). Moreover, mean_x000D_ INR (International normalized ratio), hemoglobin, hematocrit, white blood cell count, neutrophil-to-lymphocyte ratio, plateletto-lymphocyte ratio, red cell distribution width, platelet distribution width and histopathological examination of the appendicitis_x000D_ revealed no statistical difference between the two groups (p > 0.05). Most importantly, comparison of surgical site infection (6.8%),_x000D_ intra-peritoneal collection (3.4%), fetal distress and preterm delivery rate (6.8%), and abortus imminens (3.4%) also showed no_x000D_ significant difference (P > 0.05). In this study, no fetal loss was recorded._x000D_ Conclusion: The results of present study suggest that LA for acute appendicitis in pregnant women can be performed safely during_x000D_ the second half of pregnancy.