Laparoscopic appendectomy versus open appendectomy in pregnancy: a population-based analysis of maternal outcome

Han-Tsung Cheng, Yu-Chun Wang, Hung-Chieh Lo, Li-Ting Su, Khay-Seng Soh, Chia-Wei Tzeng, Shih-Chi Wu, Fung-Chang Sung, Chi-Hsun Hsieh

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background Laparoscopic appendectomy (LA) is the standard treatment of acute appendicitis for the general population; however, there is still some doubt regarding its safety for pregnant patients. Therefore, the purpose of this study is to investigate and compare the maternal outcome of pregnant patients with acute appendicitis following either an open appendectomy (OA) or LA from a population-based database. Methods This study is based on the National Health Insurance Research Database. Patients with both ICD-9-CM codes for appendicitis (540.9, 540.0, and 540.1) and pregnancy (V22) in the same admission were considered to have acute appendicitis during pregnancy. These patients were divided into three groups according to the type of treatment: LA, OA, and non-operative treatment. Outcome measures that were compared between the groups included maternal complications such as preterm labor, abortion, and the need of cesarean section. Besides, the differences of medical expenditure and length of hospital stay between the groups were also analyzed. Results From 2005 to 2010, a total of 859 pregnant women who had acute appendicitis were identified. They had increased risks for preterm labor, abortion, and increased requirement of cesarean section compared to the control group (i.e., those without acute appendicitis). Among the three groups, the non-operated group has the highest risk of preterm labor. Patients who underwent LA did not have any increased risk of maternal complications compared to the OA group. Furthermore, LA patients had shorter hospital stay than OA. Conclusion Compared to non-operative treatment, appendectomy is the preferred treatment for pregnant patients who have acute appendicitis. LA can be performed safely in pregnant patients without bringing additional maternal complications compared to OA. © 2014 Springer Science+Business Media New York.
Original languageEnglish
JournalSurgical Endoscopy
DOIs
Publication statusPublished - 2014

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Appendectomy
Mothers
Appendicitis
Pregnancy
Population
Premature Obstetric Labor
Length of Stay
Cesarean Section
Databases
Therapeutics
National Health Programs
International Classification of Diseases
Patient Safety
Health Expenditures
Pregnant Women
Outcome Assessment (Health Care)

Keywords

  • Abdominal
  • Digestive
  • General
  • Gynecology and obstetrics
  • Surgical

Cite this

Laparoscopic appendectomy versus open appendectomy in pregnancy: a population-based analysis of maternal outcome. / Cheng, Han-Tsung; Wang, Yu-Chun; Lo, Hung-Chieh; Su, Li-Ting; Soh, Khay-Seng; Tzeng, Chia-Wei; Wu, Shih-Chi; Sung, Fung-Chang; Hsieh, Chi-Hsun.

In: Surgical Endoscopy, 2014.

Research output: Contribution to journalArticle

Cheng, Han-Tsung ; Wang, Yu-Chun ; Lo, Hung-Chieh ; Su, Li-Ting ; Soh, Khay-Seng ; Tzeng, Chia-Wei ; Wu, Shih-Chi ; Sung, Fung-Chang ; Hsieh, Chi-Hsun. / Laparoscopic appendectomy versus open appendectomy in pregnancy: a population-based analysis of maternal outcome. In: Surgical Endoscopy. 2014.
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abstract = "Background Laparoscopic appendectomy (LA) is the standard treatment of acute appendicitis for the general population; however, there is still some doubt regarding its safety for pregnant patients. Therefore, the purpose of this study is to investigate and compare the maternal outcome of pregnant patients with acute appendicitis following either an open appendectomy (OA) or LA from a population-based database. Methods This study is based on the National Health Insurance Research Database. Patients with both ICD-9-CM codes for appendicitis (540.9, 540.0, and 540.1) and pregnancy (V22) in the same admission were considered to have acute appendicitis during pregnancy. These patients were divided into three groups according to the type of treatment: LA, OA, and non-operative treatment. Outcome measures that were compared between the groups included maternal complications such as preterm labor, abortion, and the need of cesarean section. Besides, the differences of medical expenditure and length of hospital stay between the groups were also analyzed. Results From 2005 to 2010, a total of 859 pregnant women who had acute appendicitis were identified. They had increased risks for preterm labor, abortion, and increased requirement of cesarean section compared to the control group (i.e., those without acute appendicitis). Among the three groups, the non-operated group has the highest risk of preterm labor. Patients who underwent LA did not have any increased risk of maternal complications compared to the OA group. Furthermore, LA patients had shorter hospital stay than OA. Conclusion Compared to non-operative treatment, appendectomy is the preferred treatment for pregnant patients who have acute appendicitis. LA can be performed safely in pregnant patients without bringing additional maternal complications compared to OA. {\circledC} 2014 Springer Science+Business Media New York.",
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author = "Han-Tsung Cheng and Yu-Chun Wang and Hung-Chieh Lo and Li-Ting Su and Khay-Seng Soh and Chia-Wei Tzeng and Shih-Chi Wu and Fung-Chang Sung and Chi-Hsun Hsieh",
note = "被引用次數:2 Export Date: 24 March 2016 Article in Press 通訊地址: Hsieh, C.-H.; Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; 電子郵件: hsiehchihsun@yahoo.com.tw",
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T1 - Laparoscopic appendectomy versus open appendectomy in pregnancy: a population-based analysis of maternal outcome

AU - Cheng, Han-Tsung

AU - Wang, Yu-Chun

AU - Lo, Hung-Chieh

AU - Su, Li-Ting

AU - Soh, Khay-Seng

AU - Tzeng, Chia-Wei

AU - Wu, Shih-Chi

AU - Sung, Fung-Chang

AU - Hsieh, Chi-Hsun

N1 - 被引用次數:2 Export Date: 24 March 2016 Article in Press 通訊地址: Hsieh, C.-H.; Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; 電子郵件: hsiehchihsun@yahoo.com.tw

PY - 2014

Y1 - 2014

N2 - Background Laparoscopic appendectomy (LA) is the standard treatment of acute appendicitis for the general population; however, there is still some doubt regarding its safety for pregnant patients. Therefore, the purpose of this study is to investigate and compare the maternal outcome of pregnant patients with acute appendicitis following either an open appendectomy (OA) or LA from a population-based database. Methods This study is based on the National Health Insurance Research Database. Patients with both ICD-9-CM codes for appendicitis (540.9, 540.0, and 540.1) and pregnancy (V22) in the same admission were considered to have acute appendicitis during pregnancy. These patients were divided into three groups according to the type of treatment: LA, OA, and non-operative treatment. Outcome measures that were compared between the groups included maternal complications such as preterm labor, abortion, and the need of cesarean section. Besides, the differences of medical expenditure and length of hospital stay between the groups were also analyzed. Results From 2005 to 2010, a total of 859 pregnant women who had acute appendicitis were identified. They had increased risks for preterm labor, abortion, and increased requirement of cesarean section compared to the control group (i.e., those without acute appendicitis). Among the three groups, the non-operated group has the highest risk of preterm labor. Patients who underwent LA did not have any increased risk of maternal complications compared to the OA group. Furthermore, LA patients had shorter hospital stay than OA. Conclusion Compared to non-operative treatment, appendectomy is the preferred treatment for pregnant patients who have acute appendicitis. LA can be performed safely in pregnant patients without bringing additional maternal complications compared to OA. © 2014 Springer Science+Business Media New York.

AB - Background Laparoscopic appendectomy (LA) is the standard treatment of acute appendicitis for the general population; however, there is still some doubt regarding its safety for pregnant patients. Therefore, the purpose of this study is to investigate and compare the maternal outcome of pregnant patients with acute appendicitis following either an open appendectomy (OA) or LA from a population-based database. Methods This study is based on the National Health Insurance Research Database. Patients with both ICD-9-CM codes for appendicitis (540.9, 540.0, and 540.1) and pregnancy (V22) in the same admission were considered to have acute appendicitis during pregnancy. These patients were divided into three groups according to the type of treatment: LA, OA, and non-operative treatment. Outcome measures that were compared between the groups included maternal complications such as preterm labor, abortion, and the need of cesarean section. Besides, the differences of medical expenditure and length of hospital stay between the groups were also analyzed. Results From 2005 to 2010, a total of 859 pregnant women who had acute appendicitis were identified. They had increased risks for preterm labor, abortion, and increased requirement of cesarean section compared to the control group (i.e., those without acute appendicitis). Among the three groups, the non-operated group has the highest risk of preterm labor. Patients who underwent LA did not have any increased risk of maternal complications compared to the OA group. Furthermore, LA patients had shorter hospital stay than OA. Conclusion Compared to non-operative treatment, appendectomy is the preferred treatment for pregnant patients who have acute appendicitis. LA can be performed safely in pregnant patients without bringing additional maternal complications compared to OA. © 2014 Springer Science+Business Media New York.

KW - Abdominal

KW - Digestive

KW - General

KW - Gynecology and obstetrics

KW - Surgical

U2 - 10.1007/s00464-014-3810-5

DO - 10.1007/s00464-014-3810-5

M3 - Article

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

ER -