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

Autor: Andrea Ciarrocchi, Gianfranco Amicucci
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Journal of Minimal Access Surgery, Vol 10, Iss 1, Pp 4-9 (2014)
Druh dokumentu: article
ISSN: 0972-9941
1998-3921
DOI: 10.4103/0972-9941.124451
Popis: 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.
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