{
    "abstract": "The optimal surgical approach to perform during pregnancy is still controversial. This study evaluated pregnancy and operative outcomes in women undergoing an appendectomy or cholecystectomy during pregnancy, and compared them between the laparoscopic and open approach using nationwide population-based data.\nBetween 2009 and 2019, a total of 2941 pregnant women with procedure codes for an appendectomy or cholecystectomy were extracted from the Korean National Health Insurance claims data (laparoscopy: 1504; open: 1437). Surgical outcomes [length of stay (LOS), anesthesia time, 30-day readmission rates, transfusion rates, second laparotomy, and 30-day mortality rates] and pregnancy outcomes (live birth rate, overall and spontaneous abortion rates, threatened abortion rate, type of delivery, preterm labor, stillbirth, fetal screening abnormalities, and intrauterine growth retardation) were compared between the open and laparoscopic groups.\nThe laparoscopic group had a significantly shorter LOS than the open group, and transfusions were less frequent in the laparoscopic group. Mortality, 30-day readmission rates, and second laparotomy were not statistically significant between the two groups. There were no significant differences in fetal loss and live birth rates between the two groups in all gestational ages. Preterm labor within 30\u00a0days of surgery was more frequent in the laparoscopy group than in the open surgery group, especially for those in their first and third trimesters. Open procedures were associated with an increased rate of cesarean sections.\nLaparoscopic surgery was found to be feasible and safe without adverse postoperative outcomes. Careful observation of postoperative preterm labor is necessary, especially for women who undergo laparoscopic surgery in their first and third trimesters.",
    "authors": [
        {
            "affiliation": "Department of Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea. leejuhee79@gmail.com.",
            "firstname": "Ju-Hee",
            "initials": "JH",
            "lastname": "Lee"
        },
        {
            "affiliation": "Department of Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.",
            "firstname": "Ji Yoon",
            "initials": "JY",
            "lastname": "Choi"
        },
        {
            "affiliation": "Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea.",
            "firstname": "Yun Jin",
            "initials": "YJ",
            "lastname": "Kim"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
    "doi": "10.1007/s00464-022-09188-9\n10.1001/jamasurg.2015.91\n10.1111/1471-0528.12736\n10.1016/j.surg.2009.03.033\n10.1002/bjs.8889\n10.1016/j.ejogrb.2018.04.010\n10.1186/s12893-019-0505-9\n10.1007/s00464-016-5019-2\n10.1111/ans.14963\n10.1016/j.ijsu.2016.01.070\n10.1016/j.jmig.2018.06.008\n10.1007/s00464-015-4244-4\n10.3389/fsurg.2021.720351\n10.1097/SLE.0000000000000943\n10.1097/MD.0000000000021801\n10.1186/s12893-019-0578-5\n10.1001/jama.2018.13201\n10.1007/s00268-021-06010-w\n10.1007/s00464-021-08315-2\n10.1007/s00464-020-08054-w\n10.1016/j.jamcollsurg.2018.12.024\n10.1007/s00464-020-07910-z\n10.1007/s00464-020-08094-2\n10.1007/s00464-020-07911-y\n10.1007/s00404-020-05767-0",
    "journal": "Surgical endoscopy",
    "keywords": [
        "Appendectomy",
        "Cholecystectomy",
        "Laparoscopy",
        "National Health Insurance (NHI) claims data",
        "Pregnancy"
    ],
    "methods": null,
    "publication_date": "2022-03-20",
    "pubmed_id": "35304619\n33527207",
    "results": "The laparoscopic group had a significantly shorter LOS than the open group, and transfusions were less frequent in the laparoscopic group. Mortality, 30-day readmission rates, and second laparotomy were not statistically significant between the two groups. There were no significant differences in fetal loss and live birth rates between the two groups in all gestational ages. Preterm labor within 30\u00a0days of surgery was more frequent in the laparoscopy group than in the open surgery group, especially for those in their first and third trimesters. Open procedures were associated with an increased rate of cesarean sections.",
    "title": "Safety of laparoscopic surgery during pregnancy: a Korean nationwide population-based study.",
    "xml": "<Element 'PubmedArticle' at 0x78850581be70>"
}