MEDICINE
REVIEW ARTICLE
Abdominal Surgery in Pregnancy—an Interdisciplinary Challenge Ingolf Juhasz-Böss, Erich Solomayer, Martin Strik, Christoph Raspé
SUMMARY Background: Abdominal operations are performed during ca. 2% of all pregnancies. They represent an unusual situation not only for the patient, but also for the involved surgeons and anesthesiologists. Appendectomy, followed by cholecystectomy are the two most common types of operation performed during pregnancy. Special questions arise with regard to the peri- and intraoperative management and the optimal surgical approach. Methods: This review is based on pertinent articles retrieved by a selective search in the PubMed database. Results: The question of laparoscopy versus laparotomy during pregnancy has been addressed to date only in case series and a few meta-analyses. Two meta-analyses have shown a significantly higher rate of miscarriage after laparoscopic, compared to open, appendectomy (relative risk [RR] 1.91, 95% confidence interval [CI] 1.31–2.77). The risk of preterm birth is also somewhat higher after laparoscopic appendectomy according to one meta-analysis on this subject (RR 1.44, 95% CI 0.78–1.76), but significantly lower according to another meta-analysis (2.1% vs. 8.1%, p
REVIEW ARTICLE
Abdominal Surgery in Pregnancy—an Interdisciplinary Challenge Ingolf Juhasz-Böss, Erich Solomayer, Martin Strik, Christoph Raspé
SUMMARY Background: Abdominal operations are performed during ca. 2% of all pregnancies. They represent an unusual situation not only for the patient, but also for the involved surgeons and anesthesiologists. Appendectomy, followed by cholecystectomy are the two most common types of operation performed during pregnancy. Special questions arise with regard to the peri- and intraoperative management and the optimal surgical approach. Methods: This review is based on pertinent articles retrieved by a selective search in the PubMed database. Results: The question of laparoscopy versus laparotomy during pregnancy has been addressed to date only in case series and a few meta-analyses. Two meta-analyses have shown a significantly higher rate of miscarriage after laparoscopic, compared to open, appendectomy (relative risk [RR] 1.91, 95% confidence interval [CI] 1.31–2.77). The risk of preterm birth is also somewhat higher after laparoscopic appendectomy according to one meta-analysis on this subject (RR 1.44, 95% CI 0.78–1.76), but significantly lower according to another meta-analysis (2.1% vs. 8.1%, p
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