LAPAROSCOPIC VS OPEN APPENDICECTOMY: WHAT’S THE BEST FOR PREGNANT PATIENTS

Abstract

Objective: To compare the post-operative outcomes in pregnant patients with appendicitis undergoing laparoscopic versus open appendicectomy.

Study Design: Comparative prospective study.

Place and Duration of Study: Surgery Department, Qazi Hussain Ahmed Medical Complex, Nowshera Pakistan, from Jan 2018 to Dec 2019.

Methodology: This study consisted of patients with acute appendicitis during pregnancy who were presented to Surgery Department or referred to it from Obstetrics and Gynecology Department. Patients were divided into 2 groups: Group A had patients who underwent Laparoscopic appendicectomyand Group B had patients who underwent Open appendicectomy. Postoperative outcomes in both groups including fetal loss, preterm delivery, operative time and surgical complications were observed. The p-value of <0.05 was considered significant.

Results: Total of 90 pregnant women were included. Group A consisted of 44 cases and 46 patients were in Group B. The mean maternal age was 24.5 ± 5.2 year (Group A) and 23.5 ± 4.2 years (Group B). About 30 patients (33.33%) were in the first trimester, 38 (42.22%) in second while 22 (24.44%) patients were in the third trimester.Wound infection occurred in two patients in Group B (p=0.08). Fetal loss occurred in one patient in Group A and in 3 patients in Group B (p=0.09). Hospital stay was significantly shorter in Group A (1.4 ± 1.9 days).

Conclusions: Laparoscopic appendectomy is safe with low incidence of post operative maternal as well as fetal complications.