Laparoscopic vs open appendectomy in obese patients / 中华普通外科杂志

ABSTRACT

Objective To evaluate laparoscopic appendectomy(LA) and open appendectomy(OA)in obese patients.Methods From January 2008 to November 2010,153 obese patients with appendicitis were operated on,92 cases were treated with initial LA and 61 cases with upfront OA.The operative time,intraoperative bleeding volume,intestinal recovery period,the rate of using acesodyne,major postoperative complications,the duration and hospital cost were studied.Results In LA group,4 cases were converted to open surgery.All the variables in LA group were better than those in OA group except the hospital cost and the differences were statistically significant (the operative timet =14.0,P ＜ 0.001 ;intraoperative bleeding volumet =19.7,P ＜ 0.00 1 ;intestinal recovery periodt =12.3,P ＜ 0.001 ;the rate of using acesodynet =21.01,P ＜ 0.001 ;main postoperative complicationsx2 =40.138,P ＜ 0.001 ;the hospital stayt=17.3,P＜0.001) except the in-hospital cost(t=1.434,P＞0.05).Conclusions Compared with OA,LA is a better choice for obese patients with appendicitis because of its advantages of minimal injury,early recovery,less complications and short hospital stay.