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Laparoscopy should be the approach of choice for acute appendicitis in the morbidly obese
J Esteban Varela1, Marcelo W Hinojosa, Ninh T Nguyen
1Department of Surgery, University of Texas Southwestern, Dallas, TX, USA. esteban.varela@utsouthwestern.edu
Background:
The current study compared the outcome of morbidly obese patients undergoing laparoscopic versus open appendectomy.
Methods:
We obtained data from the University HealthSystem Consortium (UHC) database on 1,943 morbidly obese patients who underwent appendectomy for acute or perforated appendicitis between 2002 and 2007.
Results:
Compared to open appendectomy, laparoscopic appendectomy was associated with a shorter length of stay (3 vs 4 days) and a lower overall complication rate (9% vs 17%). Most notably, a lower rate of wound infection was noted (1% vs 3%). Within a subset analysis of morbidly obese patients who underwent appendectomy for perforated appendicitis, there was a higher overall complication rate (27% vs 18%) and cost ($16,600 vs $12,300) in the open appendectomy group.
Conclusion:
In the morbidly obese, laparoscopic appendectomy performed for acute and perforated appendicitis is associated with a shorter length of stay and lower morbidity and costs. Laparoscopic appendectomy should be the procedure of choice for the treatment of acute appendicitis in the morbidly obese population.
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