Document Detail


Systematic review and meta-analysis of safety of laparoscopic versus open appendicectomy for suspected appendicitis in pregnancy.
MedLine Citation:
PMID:  23001791     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Laparoscopic appendicectomy has gained wide acceptance as an alternative to open appendicectomy during pregnancy. However, data regarding the safety and optimal surgical approach to appendicitis in pregnancy are still controversial.
METHODS: This was a systematic review and meta-analysis of studies comparing laparoscopic and open appendicectomy in pregnancy identified using PubMed and Scopus search engines from January 1990 to July 2011. Two reviewers independently extracted data on fetal loss, preterm delivery, wound infection, duration of operation, hospital stay, Apgar score and birth weight between laparoscopic and open appendicectomy groups.
RESULTS: Eleven studies with a total of 3415 women (599 in laparoscopic and 2816 in open group) were included in the analysis. Fetal loss was statistically significantly worse in those who underwent laparoscopy compared with open appendicectomy; the pooled relative risk (RR) was 1·91 (95 per cent confidence interval (c.i.) 1·31 to 2·77) without heterogeneity. The pooled RR for preterm labour was 1·44 (0·68 to 3·06), but this risk was not statistically significant. The mean difference in length of hospital stay was - 0·49 (-1·76 to - 0·78) days, but this was not clinically significant. No significant difference was found for wound infection, birth weight, duration of operation or Apgar score.
CONCLUSION: The available low-grade evidence suggests that laparoscopic appendicectomy in pregnant women might be associated with a greater risk of fetal loss.
Authors:
C Wilasrusmee; B Sukrat; M McEvoy; J Attia; A Thakkinstian
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review     Date:  2012-09-21
Journal Detail:
Title:  The British journal of surgery     Volume:  99     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-02     Completed Date:  2012-12-17     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1470-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Surgery, Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Descriptor/Qualifier:
Adult
Appendectomy / methods,  standards*
Appendicitis / surgery*
Female
Fetal Death / etiology
Humans
Laparoscopy / methods,  standards*
Length of Stay
Obstetric Labor, Premature / etiology
Operative Time
Patient Safety
Pregnancy
Pregnancy Complications / surgery*
Pregnancy Outcome
Comments/Corrections
Comment In:
Br J Surg. 2012 Nov;99(11):1478-9   [PMID:  23027069 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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