Desfechos materno-fetais da apendicectomia na gestação: uma comparação entre técnica aberta e laparoscópica

Abstract

Recent publications have sought to compare maternal and fetal outcomes related to open or laparoscopic appendectomy during gestation. The results so far are conflicting, especially with regard to fetal outcomes. In this sense, the objective of the present review was to critically analyze current evidence on maternal-fetal outcomes in the comparison between the open technique and the laparoscopic technique in the gestational period. A systematic review of articles was conducted for this study, in the databases PUBMED, SCIELO, LILACS and SCOPUS. Descriptors: "appendectomy", "open appendectomy", "laparoscopic appendectomy" "maternal complications", "fetal complications", "pregnancy". All studies published between 2008 and 2018 were included, and after exclusion of the duplicates and the studies that deviated from the proposed objective, 11 studies were included in the analysis. Overall, results on maternal outcomes show that the laparoscopic technique was associated with a shorter hospitalization time, a lower prevalence of surgical wound infections, and general postoperative complications. Regarding fetal outcomes, there was no statistically significant difference between abortion rate, prematurity or APGAR between the two techniques. It was concluded that laparoscopic appendectomy was not associated with worse fetal and / or maternal outcomes and that, in fact, some maternal outcomes were benefited by such an approach, without incurring any additional harm to the fetus. Limitations of most of the available evidence, especially since they are retrospective and small case studies, have influenced the results found and compromised the initially proposed analysis. New controlled studies are needed to better understand the topic.