Laparoscopic appendectomy in patients with a body mass index of 25 or greater: results of a double blind, prospective, randomized trial.
BACKGROUND
The reported advantages of the laparoscopic approach to appendectomy are shortened hospital stay, less postoperative pain, and earlier return to usual activities (work). However, a prospective, randomized, double-blind trial comparing laparoscopic appendectomy with open appendectomy in active-duty males failed to disclose a benefit of laparoscopic appendectomy with regards to postoperative pain and return to work. The aim of our study was to compare open and laparoscopic appendectomy in overweight patients.


METHODS
We conducted a prospective, randomized, double-blind study to determine whether laparoscopic appendectomy or the open procedure in overweight patients offers a significant reduction in lost workdays, postoperative pain, or operative time from. Open appendectomy in overweight patients (those with a body mass index > or =25) may be more difficult due to excessive subcutaneous adipose tissue. The open incision may be of considerable size, which may result in increased postoperative pain and a prolonged convalescence.


RESULTS
There was a statistically significant increase in operative time for laparoscopic appendectomy of 11 minutes. As expected, the aggregate incision length for open appendectomy was twice that of the laparoscopic appendectomy.


CONCLUSIONS
The data from this prospective, randomized, double-blind study failed to demonstrate any significant reduction in lost workdays, postoperative pain, or operative time with laparoscopic appendectomy.
Department of General Surgery, Naval Medical Center, Portsmouth, Virginia 23708, USA.
Robert
R
Ricca
James J
JJ
Schneider
Harpreet
H
Brar
Paul A
PA
Lucha
D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000473:pathology / Q000601:surgery; D015992:Body Mass Index; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D050177:Overweight; D010149:Postoperative Pain