Related Experiment Video
Updated: Jan 6, 2026
09:51
Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
1.6K
Laparoscopic Appendectomy Is Superior in Patients with Higher Fat Thickness
Emre Teke1,2,3,4,5, Evren Besler1,2,3,4,5, Hatice Büşra Özdilek1,2,3,4,5
1General Surgery Department, University of Health Sciences, Gaziantep City Hospital, Gaziantep, Türkiye. (Dr. Teke).
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|December 3, 2025
Summary
Laparoscopic appendectomy (LA) shows better results than open appendectomy (OA) for acute appendicitis, especially in patients with higher subcutaneous fat thickness (SFT). SFT measurement on CT scans improves surgical risk assessment.
Area of Science:
- General Surgery
- Radiology
- Medical Imaging
Background:
- Acute appendicitis (AA) is a common surgical emergency.
- Laparoscopic appendectomy (LA) offers benefits over open appendectomy (OA), but surgical site infection (SSI) remains a concern.
- Obesity is a risk factor for SSI, yet body mass index (BMI) may not accurately reflect fat distribution; subcutaneous fat thickness (SFT) measured via computed tomography (CT) may be a better predictor.
Purpose of the Study:
- To compare the outcomes of LA and OA for AA.
- To evaluate the predictive value of SFT for SSI after appendectomy.
- To determine the optimal SFT threshold for identifying patients at high risk of SSI.
Main Methods:
- Retrospective analysis of 1,231 patients undergoing LA or OA for AA (2017-2022).
- Preoperative SFT measured on CT scans, with analysis by surgical technique and SFT subgroups.
- Recording of postoperative complications, including SSI, and use of receiver operating characteristic (ROC) analysis to identify SSI risk thresholds.
Main Results:
- LA was associated with shorter operative time, reduced hospital stay, and significantly lower SSI rates (5.6% vs 13.5%) compared to OA.
- Despite similar BMIs, LA patients had higher SFT, indicating a nonlinear relationship.
- SFT ≥33 mm was identified as a strong predictor of SSI (AUC = 0.841), with LA demonstrating significantly fewer SSIs and shorter hospitalizations in this subgroup.
Conclusions:
- Laparoscopic appendectomy (LA) provides superior outcomes to open appendectomy (OA), especially for patients with greater subcutaneous fat thickness (SFT).
- Subcutaneous fat thickness (SFT) measured by CT is a more reliable indicator of surgical risk than BMI.
- Integrating SFT into preoperative assessments can optimize surgical strategy and enhance patient outcomes for acute appendicitis.
