Laparoscopic vs open appendectomy in overweight patients.

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Bariatric Surgery Outcomes

Background:

• Laparoscopic appendectomy (LA) generally offers faster recovery and reduced pain versus open appendectomy (OA).
• Limited clinical data exist on LA outcomes specifically in overweight patient populations.

Purpose of the Study:

• To evaluate the clinical outcomes of laparoscopic appendectomy (LA) versus open appendectomy (OA) in overweight patients.

Main Methods:

• A prospective randomized study included 106 overweight patients (BMI > 26.4).
• Patients were randomized to undergo either LA or OA.
• Key outcomes measured included operating time, pain, complications, hospital stay, and recovery duration.

Main Results:

• Overweight patients undergoing OA had longer operating times, greater postoperative pain, longer hospital stays, and extended sick leave compared to normal-weight patients.
• Laparoscopic appendectomy (LA) in overweight patients resulted in less postoperative pain and faster recovery than OA.
• LA abolished some negative effects of overweight on operating time, hospital stay, and sick leave compared to OA.
• However, LA was associated with longer operating and anesthesia times for both overweight and normal-weight patients compared to OA.

Conclusions:

• Laparoscopic appendectomy (LA) provides superior postoperative pain control and faster recovery for overweight individuals compared to open appendectomy (OA).
• LA effectively mitigates several adverse effects associated with overweight status in patients undergoing appendectomy.
• Despite longer operative times, LA demonstrates significant benefits for overweight patients regarding recovery and pain management.