Laparoscopic surgery during pregnancy
Laparoscopic surgery during pregnancy
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DOI：
10.1097/00006254-200101000-00025
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发表时间：
2001-01-01
影响因子：
6.2
通讯作者：
Rojansky, N
中科院分区：
文献类型：
--
作者：
Fatum, M;Rojansky, N
在过去的十年中，腹腔镜手术越来越多地在妇科和普外科进行。这种新的微创方法的主要优点是：降低术后发病率，减少疼痛和减少对镇痛剂的需求，早期恢复正常的bower功能，缩短住院时间，并早日恢复正常活动。随着腹腔镜手术的进步，其在妊娠期间的使用越来越被广泛接受。最常见的报告腹腔镜手术在怀孕期间是腹腔镜胆囊切除术（LC）。妊娠期间常进行的其他腹腔镜手术包括：附件包块的处理、卵巢扭转、卵巢囊肿、阑尾切除术和异位妊娠。妊娠期间腹腔镜手术可能的缺点包括妊娠子宫的损伤和由于妊娠子宫的质量增加而导致的腹腔镜手术的技术难度。此外，子宫血流量减少继发于腹内压增加的潜在风险和二氧化碳吸收到母亲和胎儿的可能风险应考虑到，到目前为止，妊娠期间腹腔镜手术的数据不足以得出结论，其安全性和确切的并发症发生率。这是由于报告的病例很少，缺乏前瞻性研究。此外，普遍存在少报不成功案件的倾向。最后，文献中的大多数报告来自对腹腔镜手术有特殊兴趣、经验和技能的中心和外科医生，其结果可能无法反映真实的并发症发生率。我们回顾了过去十年的相关英语文献。累积的经验表明，腹腔镜手术可以在怀孕期间安全地进行，尽管需要更多的研究来确定其确切的不良事件发生率。
In the last decade, operative laparoscopic procedures are performed increasingly in both gynecology and general surgery. The major advantages of this newer minimally invasive approach are: decreased postoperative morbidity, less pain and decreased need for analgesics, early normal bower function, shorter hospital stay, and early return to normal activity. With the advancement of laparoscopic surgery, its use during pregnancy is becoming more widely accepted. The most commonly reported laparoscopic operation during pregnancy is laparoscopic cholecystectomy (LC). Other laparoscopic procedures commonly performed during pregnancy include: management of adnexal mass, ovarian torsion, ovarian cystectomy, appendectomy, and ectopic pregnancy.The possible drawbacks of laparoscopic surgery during pregnancy may include injury of the pregnant uterus and the technical difficulty of laparoscopic surgery due to the growing mass of the gravid uterus. Also, the potential risk of decreased uterine blood flow secondary to the increase in intraabdominal pressure and the possible risk of carbon dioxide absorption to both the mother and fetus should be taken into account.To date, data on laparoscopic surgery during pregnancy are insufficient to draw conclusions on its safety and exact complication rate. This is due to the few cases reported and the lack of prospective studies. Furthermore, there is a common tendency to underreport unsuccessful cases. Finally, most reports in the literature come from centers and surgeons with special interest, experience, and skills in laparoscopy, and their results may not reflect the real complication rates. We have reviewed the pertinent English literature from the last decade. The cumulative experience suggests that laparoscopic surgery may be performed safely during pregnancy, although more studies are needed to establish its exact rate of adverse events.