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Review
. 2014 Jan;10(1):4-9.
doi: 10.4103/0972-9941.124451.

Laparoscopic versus open appendectomy in obese patients: A meta-analysis of prospective and retrospective studies

Andrea Ciarrocchi  1 , Gianfranco Amicucci  1
Affiliations
Review

Laparoscopic versus open appendectomy in obese patients: A meta-analysis of prospective and retrospective studies

Andrea Ciarrocchi et al. J Minim Access Surg. 2014 Jan.

Abstract

Background: A meta-analysis of different kinds of studies was performed to assess outcomes of laparoscopic versus open appendectomy in obese patients.

Materials and methods: Retrospective and prospective studies enrolling patients with a body mass index greater than 30 kg/m(2) were included. Primary outcomes were days of hospital stay, surgical procedure duration, and overall post-operative complication rate. Secondary outcomes were wound infection and intra-abdominal abscesses formation rate, hospital charges.

Results: Laparoscopic appendectomy showed to be significantly associated with lower wound infection (P < 0.001) and post-operative complication rate (P < 0.001). Surgical time was considered as a hallmark of technical challenge and resulted diminished in the laparoscopic group (P = 0.018). Although not clinically relevant per se, the statistically significant shorter hospital stay (P < 0.001) was probably the reason of decreased hospital charges (P < 0.001). Intra-abdominal abscesses formation rate was higher in the open appendectomy group (P = 0.058), although slightly above the statistical significance threshold.

Conclusion: Laparoscopic approach seemed to show relevant advantages compared to open appendectomy, but a large prospective trial is necessary to collect high quality data and investigate long-term outcomes.

Keywords: Acute appendicitis; laparoscopic appendectomy; obesity; open appendectomy.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Flow chart of paper selection
Figure 2
Figure 2
Forest plot of hospital stay
Figure 2b
Figure 2b
Funnel plot of hospital stay
Figure 3
Figure 3
Forest plot of surgical time
Figure 3b
Figure 3b
Funnel plot of surgical time
Figure 4
Figure 4
Forest plot of post-operative complication rate
Figure 4b
Figure 4b
Funnel plot of post-operative complication rate
Figure 5
Figure 5
Forest plot of wound infection rate
Figure 6
Figure 6
Forest plot of intra-abdominal abscesses formation rate
Figure 7
Figure 7
Forest plot of hospital charges
See this image and copyright information in PMC

References

    1. Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;10:CD001546. - PubMed
    1. Towfigh S, Chen F, Katkhouda N, Kelso R, Sohn H, Berne TV, et al. Obesity should not influence the management of appendicitis. Surg Endosc. 2008;22:2601–5. - PubMed
    1. Corneille MG, Steigelman MB, Myers JG, Jundt J, Dent DL, Lopez PP, et al. Laparoscopic appendectomy is superior to open appendectomy in obese patients. Am J Surg. 2007;194:877–80. - PubMed
    1. Masoomi H, Nguyen NT, Dolich MO, Wikholm L, Naderi N, Mills S, et al. Comparison of laparoscopic versus open appendectomy for acute nonperforated and perforated appendicitis in the obese population. Am J Surg. 2011;202:733–8. - PubMed
    1. Varela JE, Hinojosa MW, Nguyen NT. Laparoscopy should be the approach of choice for acute appendicitis in the morbidly obese. Am J Surg. 2008;196:218–22. - PubMed

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