Safety of laparoscopic appendicectomy during pregnancy: a systematic review and meta-analysis
| Autor: | Joseph C Kong, Peter Gourlas, Wai Kin Su, Bradley Morris, Nicholas Lutton, Timothy Slack, Christopher Gillespie, Joy Chakraborty |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Operative Time Lower risk Perioperative Care 03 medical and health sciences 0302 clinical medicine Pregnancy Outcome Assessment Health Care medicine Appendectomy Humans Obstetrics business.industry Incidence General Medicine Odds ratio Length of Stay medicine.disease Appendicitis Confidence interval Observational Studies as Topic Systematic review Strictly standardized mean difference 030220 oncology & carcinogenesis Meta-analysis Case-Control Studies Acute Disease Premature Birth 030211 gastroenterology & hepatology Surgery Observational study Female Laparoscopy Safety business |
| Zdroj: | ANZ journal of surgeryReferences. 89(11) |
| ISSN: | 1445-2197 |
| Popis: | BACKGROUND Acute appendicitis is the most common non-obstetric surgical presentation during pregnancy. There were concerns that laparoscopic appendicectomy increases the risk of foetal loss compared to an open approach. Therefore, with recent advances in perioperative care, it is likely the risk has changed. Here, we performed an updated meta-analysis assessing the safety of laparoscopic appendicectomy in pregnant women. METHODS A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was undertaken between 2000 and 2017 on Ovid Medline and Embase. The primary outcome measures were foetal loss and preterm delivery, whereas secondary outcome measures were operative time and hospital length of stay. A random-effect model was performed to pool odds ratio (OR) and standardized mean difference (SMD). RESULTS Seventeen observational studies were included, with 1886 patients in the laparoscopic and 4261 patients in the open group. Comparing laparoscopic versus open appendicectomy, there were 54 (5.96%) and 136 (3.73%) foetal losses, respectively. However, preterm delivery was much higher in the open approach (8.99%) compared to laparoscopic approach (2.84%). Pooled OR for foetal loss was 1.84 (95% confidence interval (CI) 1.31-2.58, P |
| Databáze: | OpenAIRE |
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