Outcomes of low-risk non-gynecological abdominal surgery in pregnant and nonpregnant women: a comparative study

Women typically undergo an appendectomy and cholecystectomy, which are the most commonly performed non-gynecological abdominal surgeries. Despite advancements, research on the safety and efficacy of laparoscopic surgery for low-risk, non-gynecological abdominal conditions in later-stage pregnant women remains limited. This study aimed to assess the efficacy and postoperative outcomes of low-risk non-gynecological abdominal surgery in female patients, including pregnant women. Female patients diagnosed with appendicitis and biliary disease were included. Based on the pregnancy status, the participants were divided into pregnant and nonpregnant groups. The study identified 11 (1%) cases of pregnancy among the 1029 female patients enrolled. Patients in the pregnant group were younger (30 {+/-} 4.7 years vs. 39 {+/-} 13.5 years, p = 0.002), more likely to undergo emergency surgery (90 vs. 21%, p = 0.001), had a higher rate of undergoing the open-entry approach (18.2 vs. 2.1%, p = 0.002), and more frequently required a postoperative drain (36.4 vs. 10.4%, p = 0.023) than did those in the nonpregnant group. The comorbidities, American Society of Anesthesiologists score, length of hospital stay, operative time, blood loss, postoperative complications, 30-day readmission rate, and mortality rate remained statistically consistent across both groups. Surgery was performed primarily for acute appendicitis in 72% of pregnant women and for biliary disease in 83% of nonpregnant women. None of the pregnant patients experienced preterm labor or fetal mortality after surgery. One patient had an abortion 8 weeks after laparoscopic appendectomy. In conclusion, the overall complication rate of non-gynecological abdominal surgery for appendicitis and biliary disease is 2%. Biliary disease is the most common indication of non-gynecological abdominal surgery among nonpregnant women, whereas appendicitis is the most common indication among pregnant women. Emergency surgery is a significant predictor of complications in pregnant women.