There are minimal data comparing laparoscopic appendectomy with open appendectomy in obese patients.
Dr Michael Corneille and colleagues from Texas, USA reviewed consecutive adult patients from 2003 to 2005.
The patients underwent an appendectomy at a University-affiliated teaching hospital.
Obesity was defined as a body mass index of 30 or greater.
Outcome measures included length of stay, surgical times, intra-abdominal abscesses, wound infections, and hospital charges.
|Wound closure occurred in 90% with laparoscopic appendectomy|
The team identified 116 patients with a mean body mass index of 35.
The researchers noted that 85 patients underwent laparoscopic appendectomy, and 12 were converted to open appendectomy.
Of these, 31% were perforated.
The team reported that 31 patients underwent open appendectomy.
Overall, 18% of patients were perforated.
Length of stay for laparoscopic appendectomy was better, at 3 days versus 6 days for open appendectomy.
The researchers found that wound closure rate was better, and occurred in 90% with laparoscopic appendectomy versus 68% for open appendectomy.
Other outcome measures were equivalent.
Dr Corneille's team commented, "Laparoscopic appendectomy is associated with shorter lengths of stay, fewer open wounds, and equivalent hospital charges and intra-abdominal abscess rates."
"Laparoscopic appendectomy should be considered the procedure of choice for obese patients with appendicitis."