Laparoscopic versus open appendectomy for the obese patient: a subset analysis from a prospective, randomized, double-blind study.
BACKGROUND
The clinical outcomes for patients randomized to either open or laparoscopic appendectomy are comparable. However, it is not known whether this is true in the subset of the adult population with higher body mass indexes (BMIs). This study aimed to compare the outcomes of open versus laparoscopic appendectomy in the obese population.


METHODS
A subgroup analysis of a randomized, prospective, double-blind study was conducted at a county academic medical center. Of the 217 randomized patients, 37 had a BMI of 30 kg/m(2) or higher. Open surgery was performed for 14 and laparoscopic surgery for 23 of these patients. The primary outcome measures were the postoperative complication rates. The secondary outcomes were operative time, length of hospital stay, time to resumption of diet, narcotic requirements, and Medical Outcomes Survey Short Form 36 (SF-36) quality-of-life data.


RESULTS
No differences in complications between the open and laparoscopic groups were found. Also, no significant differences were seen in any of the secondary outcomes except for a longer operative time among the obese patients.


CONCLUSIONS
In this study, laparoscopic appendectomy did not show a benefit over the open approach for obese patients with appendicitis.
Department of Surgery, Keck School of Medicine of the University of Southern California and Los Angeles County-UCS Medical Center, 1200 N State Street Suite 6A231-A, Los Angels, CA 90033, USA.
Tatyan
T
Clarke
Namir
N
Katkhouda
Rodney J
RJ
Mason
Bon C
BC
Cheng
Jaisa
J
Olasky
Helen J
HJ
Sohn
Ashkan
A
Moazzez
Jeffrey
J
Algra
Eric
E
Chaghouri
Thomas V
TV
Berne
D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000379:methods* / Q000706:statistics & numerical data; D001064:Appendicitis / Q000150:complications / Q000601:surgery*; D015992:Body Mass Index; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007813:Laparotomy / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D009765:Obesity / Q000150:complications*; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D009294:Narcotics