Laparoscopic Surgery During Pregnancy Is Feasible And Safe

Objective:The case data of patients undergoing abdominal surgery for non-obstetric factors during pregnancy were retrospectively analyzed,and the patients were divided into laparoscopic surgery group and open surgery group.The effects of the two treatment methods on pregnancy outcome were analyzed,and the safety and feasibility of laparoscopic surgery during pregnancy were discussed.Methods:Information of 80 cases of non-obstetric operation during pregnancy admitted to liaocheng people’s hospital from January 2003 to June 2018 was collected,patients’ age,gestational age at surgery,surgical method,operating time,estimated blood loss,postoperative complications,pregnancy outcome(including abortion,preterm birth,full-term birth,fetal malformation).Birthweight,gestational age at delivery,1-min Apgar score were included.Compare the clinical data and the pregnancy outcome and the long-term growth and development of the live fetus were followed up.The differences between the laparoscopic surgery group and the open surgery group were statistically analyzed.Results:1.Laparoscopic surgery was performed in 30 cases(37.5%)during pregnancy,including 4 cases of single-port laparoscopic surgery and 50 cases of open surgery(62.5%),There were 37 cases of ovarian tumor and 43 cases of appendicitis.2.General data of patients in different surgery groups were not statistically significant.3.The operative time between the laparoscopic group and the open surgery group was 55.57±19.63 minutes vs 64.92±18.58 minutes,and the difference between the two groups was statistically significant(P=0.036).Intraoperative blood loss was 40.67±17.28 ml vs 49.48±18.92 ml,and the difference between the two groups was statistically significant(P=0.041).Postoperative hospitalization days were:4.63±2.99 days vs 7.06±3.50 days,the difference between the two groups was statistically significant(P=0.02),the number of postoperative complications was 2cases(6.7%)vs8 cases(16%),the difference between the two groups was not statistically significant(P=0.383).4.The operative time of patients undergoing single-port laparoscopic surgery was 76.25±22.86 minutes,which was different from traditional laparoscopic surgery(P=0.021),and the intraoperative blood loss was 41.25±6.29 ml,with no statistical difference between the two(P=0.944).No postoperative complications occurred,and the postoperative hospital stay was 4.0±0.82 days,with no statistical difference between the two(P=0.657).5.There was no statistically significant difference in postoperative complications among patients with different disease types(P=0.150),and there was no statistically significant difference in postoperative complications among patients with different diseases in different surgical methods.There was no statistically significant difference in the incidence of complications in different surgical procedures in patients with pregnancy complicated with appendicitis(P=0.699).There was no statistically significant difference in complications in different surgical methods among patients with pregnancy complicated by adnexal mass(P=0.517).However,there was no statistically significant difference in the complications of pregnancy complicated with appendicitis in different pathological types(P=0.413).6.In the open group,4 cases had miscarriage,6 cases had preterm birth,and 40 cases had full-term birth.In the laparoscopic group,2 cases had miscarriage,1 case had preterm birth,and 27 cases had full-term birth.However,there were statistically significant differences in the occurrence of abortion and preterm birth in different pathological types of appendicitis(P=0.038).7.The gestational age of neonatal delivery in the laparoscopic surgery group and the open surgery group was 37.79±1.62 weeks vs 37.63±2.10 weeks,respectiveely,and the difference between the two groups was not statistically significant(P=0.739).The newborn weight was 3333.93±4233.18 kg vs 3166.52±536.93 kg,and there was no significant difference between the two groups(P=0.165).Neonatal1-minute score was 9.64±0.56 vs 9.52±1.11,and the difference between the two groups was not statistically significant(P=0.593).Neonatal malformation and neonatal death were not found in either group.The gestational weeks of delivery and pregnancy in the single-port laparoscopic group were 37.5±0.58 weeks,which showed no statistical difference from the traditional laparoscopic surgery(P=0.711).The weight of the newborn was 3450.0±212.13 kg,which was not statistically differ-rent from the traditional laparoscopic surgery(P=0.563).The 1min score was 9.75±0.50,which was not statistically different from traditional laparoscopic surgery(P=0.687).Conclusion:1.Compared with open surgery,laparoscopic surgery is safe and feasible.It can shorten the operation time,reduce intraoperative blood loss and shorten the hospital stay without increasing postoperative complications.2.Laparoscopic surgery can be performed in all stages of pregnancy without increasing the rate of fetal malformation and adverse pregnancy outcomes.3.The occurrence of postoperative adverse events and fetal loss may be related to pathological types.