LAPAROSCOPIC VERSUS OPEN APPENDECTOMY IN MORBIDLY OBESE PATIENTS: RETROSPECTIVE STUDY
Mohamed S Essa, Mohamed E Zayed
Department of General Surgery, Benha University Hospital, Faculty of Medicine, Benha University, Benha, Egypt
Background: We are trying to detect the optimum approach for appendectomy in morbidly obese patients by evaluating laparoscopic appendectomy (LA) and open appendectomy (OA) techniques applied in this group of patients. Material and Methods: The records of 314 patients who underwent appendectomy for acute appendicitis between August 2016 and August 2018 were analyzed retrospectively. Exclusion criteria were: those under 18 years, body mass index (BMI) 40 kg/m2, and those with a perforation and/or appendicular mass. The remaining 105 patients were involved in the study. The patients were classified into 2 groups: group A, includes 50 patients underwent LA and group B, includes 55 patients underwent OA. Socio-demographic data, operative time, surgery-related superficial surgical site infection (sSSI), intra-abdominal complication, non-surgical complication, and length of postoperative hospital stay were recorded. Results: No statistically significant variations was detected between LA and OA groups in terms of age and gender (P=0.51, P=0.69 respectively). However, the average BMI value in the LA group was found to be significantly higher (P<0.001). Operative duration and length of hospital stay were shown to be significantly lower in the LA group (P<0.001, P<0.001, respectively). Overall complications and superficial SSI were found to be significantly lower in the LA group (P=0.023, P=0.032, respectively). Conclusion: Inspite of LA did not have an obvious advantage over OA in morbidly obese patients; it should be emphasized that laparoscopic surgery may be preferred because of many advantages such as a shorter length of postoperative hospital stay and minimal risk of SSI.