Surgical outcomes of laparoscopic and open appendectomy in pregnant patients: A single-center retrospective cohort study.

Objective: Acute appendicitis is the most common non-obstetric surgical emergency in pregnancy and is associated with increased maternal morbidity and risk of preterm delivery. Diagnostic difficulty rises with advancing gestation, contributing to delayed diagnosis and higher negative appendectomy rates. This retrospective study compared surgical outcomes between laparoscopic and open appendectomy in pregnant patients and assessed trimester-specific trends. Material and Methods: This retrospective single-center cohort study included pregnant patients who underwent appendectomy between June 2020 and December 2023. The final cohort of 50 cases met the inclusion criteria. Primary outcomes were maternal postoperative complications and preterm birth; secondary outcomes included operative time and length of stay (LOS). Continuous variables were non-normally distributed and are summarized as median (range). Group comparisons were performed using the Mann-Whitney U and Fisher's exact tests. Results: Appendectomies were performed during the first (26%), second (60%), and third trimesters (14%). Laparoscopic appendectomy accounted for 48% of cases. Operative time was significantly shorter in the laparoscopic group compared with the open approach (47 vs. 58 minutes, p=0.044). No significant differences were observed in postoperative complications, LOS, or preterm birth. The overall negative appendectomy rate was 8%, increasing to 28.6% in the third trimester, consistent with greater diagnostic difficulty in late gestation. Conclusion: Laparoscopic appendectomy is a safe and feasible option during pregnancy, providing comparable maternal and obstetric outcomes to open surgery while offering shorter operative times. Larger prospective studies are needed to clarify trimester-specific management, particularly in late gestation.