Laparoscopic appendectomy is superior to open appendectomy in obese patients - 21/08/11
, Megan B. Steigelman, M.D., John G. Myers, M.D., Jason Jundt, B.S., Daniel L. Dent, M.D., Peter P. Lopez, M.D., Stephen M. Cohn, M.D., Ronald M. Stewart, M.D.
Corresponding author. Tel.: +1-210-567-3623; fax: +1-210-567-0003.Abstract |
Background |
There are minimal data comparing laparoscopic appendectomy (LA) with open appendectomy (OA) in obese patients.
Methods |
We reviewed consecutive adult patients from 2003 to 2005 who underwent an appendectomy at a University-affiliated teaching hospital. Obesity was defined as a body mass index of 30 or greater. Outcome measures included length of stay, surgical times, intra-abdominal abscesses, wound infections, and hospital charges.
Results |
There were 116 patients with a mean body mass index of 35. Eighty-five patients underwent LA, 12 were converted to open, 4 of 12 (31%) were perforated. Thirty-one patients underwent OA. Overall, 21 (18%) were perforated. Length of stay for LA was better, 3.4 days versus 5.5 days for OA (P = .02), and wound closure rate was better, 90% for LA versus 68% for OA (P < .01). Other outcome measures were equivalent.
Conclusions |
LA is associated with shorter lengths of stay, fewer open wounds, and equivalent hospital charges and intra-abdominal abscess rates; and should be considered the procedure of choice for obese patients with appendicitis.
Le texte complet de cet article est disponible en PDF.Keywords : Laparoscopy, Appendicitis, Appendectomy, Laparoscopic appendectomy, Obesity, Wound infection
Plan
Vol 194 - N° 6
P. 877-881 - décembre 2007 Retour au numéro
Article précédent
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