Obesity and single-incision laparoscopic appendectomy in children

Area of Science:

• Pediatric surgery
• Minimally invasive surgery

Background:

• Single-incision laparoscopic appendectomy (SILA) offers a less invasive approach compared to traditional laparoscopy.
• Assessing the impact of body habitus on SILA outcomes in children is crucial for surgical practice.

Purpose of the Study:

• To evaluate the effect of body mass index (BMI) percentiles on outcomes following SILA in pediatric patients.
• To determine if overweight and obesity influence surgical results in children undergoing SILA.

Main Methods:

• Retrospective review of 413 pediatric patients who underwent SILA between 2012 and 2015.
• Patients categorized into normal weight, overweight, and obese groups based on CDC BMI percentiles.
• Analysis of demographic data and key surgical outcomes including operative time, length of stay, and complications.

Main Results:

• No significant differences observed in age, time to diagnosis, or intraoperative appendicitis classification across weight groups.
• Operative time, postoperative length of stay, surgical site infections, emergency department visits, and readmissions were comparable among normal, overweight, and obese children.
• Specific outcomes like operative time (27-28 min), LOS (0.97-1.53 days), and SSI rates (6.9-12.1%) showed no statistically significant variations.

Conclusions:

• Obesity does not significantly impact patient outcomes after single-incision laparoscopic appendectomy in the pediatric population.
• SILA is a viable and safe option for overweight and obese children, yielding similar results to normal-weight children.
• The study supports the continued use of SILA for pediatric appendectomies regardless of patient BMI.