Our Summary

This research paper discusses the treatment of acute appendicitis in pregnant women. It is still unclear whether the best method of removing the appendix during pregnancy is through traditional open surgery (Open Appendectomy - OA) or using a less invasive laparoscopic method (Laparoscopic Appendectomy - LA).

The study looked at the medical records of pregnant women who had their appendix removed between 2000 and 2012. There were 25 cases of open surgery and 19 cases of laparoscopic surgery.

The researchers found that the laparoscopic surgery took a bit longer (69 minutes compared to 49 minutes with open surgery), but had fewer complications, shorter hospital stays, and fewer instances where the appendix was removed unnecessarily. There were no significant differences in the outcomes for the babies (like birth weight or time of birth) between the two methods.

Only 5 births (11%) happened a bit earlier than expected, but there were no cases of fetal loss. This means that the laparoscopic method is safe for both the mother and baby, regardless of how far along the pregnancy is, and has a low risk of complications after the surgery.

The study did not receive any specific funding and was not part of a clinical trial.

FAQs

  1. Is laparoscopic appendectomy safe for pregnant women?
  2. What are the benefits of laparoscopic appendectomy compared to open appendectomy during pregnancy?
  3. Were there any cases of fetal loss observed in the study of pregnant women who underwent appendectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about appendectomy is to discuss the option of laparoscopic appendectomy with them. This procedure has been shown to have fewer complications, shorter hospital stays, and lower rates of negative appendectomies compared to open appendectomy. It is also safe for both the mother and the fetus during pregnancy, regardless of gestational age. Be sure to talk to your doctor about the best treatment option for you.

Suitable For

Patients who are typically recommended appendectomy include those who are pregnant and experiencing symptoms of acute appendicitis. This study found that laparoscopic appendectomy is safe for both the mother and the fetus during pregnancy, with lower rates of complications, shorter hospital stays, and a lower rate of negative appendectomies compared to open appendectomy. The procedure was found to be associated with a low risk of post-operative complications and did not result in any cases of fetal loss.

Timeline

Before appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient seeks medical attention and undergoes physical examination, blood tests, and imaging studies to confirm the diagnosis.
  3. The decision is made to proceed with an appendectomy, either open or laparoscopic.

After appendectomy:

  1. The patient undergoes surgery, with laparoscopic appendectomy generally resulting in shorter operation time.
  2. The patient experiences a shorter hospital stay and lower risk of complications with laparoscopic appendectomy compared to open appendectomy.
  3. The patient may give birth at a similar gestational age regardless of the type of appendectomy performed.
  4. There is no significant difference in birth outcomes between the two groups, with no cases of fetal loss reported.
  5. Laparoscopic appendectomy is deemed safe for both the mother and the fetus during pregnancy, with a low risk of post-operative complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about appendectomy include:

  1. What are the risks and benefits of laparoscopic appendectomy compared to open appendectomy during pregnancy?
  2. How will the surgery affect my pregnancy and the health of my baby?
  3. What is the recovery process like after appendectomy during pregnancy?
  4. Will the anesthesia used during the surgery have any impact on my baby?
  5. How soon after the surgery can I resume normal activities and return to work?
  6. Are there any dietary or lifestyle restrictions I need to follow post-surgery?
  7. What signs or symptoms should I watch out for after the surgery that might indicate complications?
  8. How will the surgery impact my ability to deliver my baby vaginally?
  9. Are there any specific follow-up appointments or tests I need to schedule after the surgery?
  10. Are there any long-term effects of appendectomy during pregnancy that I should be aware of?

Reference

Authors: Laustsen JF, Bjerring OS, Johannessen Ø, Qvist N. Journal: Dan Med J. 2016 Aug;63(8):A5259. PMID: 27477796