Pediatric Obesity's Effect on Open and Laparoscopic Appendectomy Outcomes

Area of Science:

• Pediatric Surgery
• Obesity Research
• Health Services Research

Background:

• Pediatric obesity is a growing concern, complicating surgical procedures like appendectomy.
• Existing research on obesity and appendectomy outcomes is limited by small sample sizes and lack of surgical approach distinction.
• The interaction between surgical approach and pediatric obesity on appendectomy outcomes remains unclear.

Purpose of the Study:

• To analyze postoperative appendectomy outcomes considering pediatric obesity, surgical approach (laparoscopic vs. open), and their interaction.
• To provide data-driven insights for optimizing pediatric appendectomy care.
• To inform resource allocation in pediatric surgical services.

Main Methods:

• Retrospective cohort analysis of nationwide pediatric inpatient data from the 2019 Kids' Inpatient Database.
• Examined outcomes including length of stay and postoperative complication rates.
• Utilized multiple regression analysis to assess the impact of pediatric obesity, surgical approach, and their interaction, controlling for patient demographics and clinical factors.

Main Results:

• Laparoscopic appendectomy (LA) resulted in a 5.8% shorter length of stay compared to open appendectomy (OA).
• Obese patients experienced a 31.8% longer length of stay than non-obese patients, but LA reduced this difference by 19% compared to OA.
• Obesity did not significantly affect postoperative complication rates, regardless of surgical approach.

Conclusions:

• While obesity increases length of stay after open appendectomy, laparoscopic appendectomy minimizes this disparity.
• Surgical approach does not influence complication rates in relation to pediatric obesity.
• Findings support tailored surgical approach selection for obese pediatric patients to optimize recovery and resource utilization.