Appendectomy during pregnancy - is pregnancy outcome depending by operation technique?

Objective: To compare perioperative and pregnancy outcome between women undergoing laparoscopic appendectomy and those undergoing open appendectomy during pregnancy for presumed acute appendicitis. Methods: A retrospective cohort study of all women undergoing appendectomy during pregnancy in a tertiary referral medical center from 2000 to 2009. Outcome was compared between those undergoing laparoscopic appendectomy and those undergoing open appendectomy. Results: Overall, 83 510 deliveries occurred during the study period, 85 (0.10%) were eligible for the study group. Of these, 26 (31%) had a laparoscopic appendectomy and 59 (69%) had an open appendectomy. No significant difference was found in the general, delivery and neonatal outcome characteristics between the two groups. There was a significant difference in the mean gestational age at surgery between laparoscopic appendectomy and the open appendectomy groups (14.6 versus 19.3 weeks respectively, p=0.009). Post-operative complications (fever >38.0 degrees C or the presence of uterine contractions) rate was higher in the open appendectomy compared to the laparoscopic appendectomy group (25.5% versus 3.8%, respectively, p=0.009). Conclusion: Laparoscopic appendectomy appears to be a safe procedure for presumed acute appendicitis during pregnancy with less post-operative complications as compared to open appendectomy.