Laparoscopic versus open appendicectomy in obese patients.

Area of Science:

• Surgical Innovation
• Obesity Medicine
• Gastrointestinal Surgery

Background:

• Laparoscopic surgery for acute appendicitis lacks clear general population benefits.
• Obese patients may experience greater advantages with a laparoscopic approach.

Purpose of the Study:

• To evaluate clinical outcomes of laparoscopic versus open appendicectomy in obese patients.
• To conduct a pooled analysis of comparative studies.

Main Methods:

• Systematic literature search across major databases (MEDLINE, Embase, Web of Science, Cochrane Library).
• Primary outcomes: operation length and hospital stay duration.
• Secondary outcomes: post-operative, wound, and intra-abdominal complications.
• Statistical analysis included weighted mean differences and pooled odds ratios.

Main Results:

• Analysis included 2309 appendicectomies (1122 laparoscopic, 1187 open).
• Laparoscopic appendicectomy was associated with a significantly shorter hospital stay (WMD = -1.26 days, p = 0.02).
• No significant differences were found in operation length or complication rates (post-operative, wound, intra-abdominal).

Conclusions:

• Laparoscopic appendicectomy may offer benefits for obese patients, primarily through reduced hospital stay.
• The incidence of post-operative complications is comparable between laparoscopic and open appendicectomy in this population.