Outcomes of laparoscopic versus open appendectomy in overweight and obese patients: The impact of surgical approach on clinical results and quality of life

INTRODUCTION: Appendectomy stands as the primary curative intervention for acute appendicitis, and the emergence of minimally invasive techniques has propelled interest in laparoscopic procedures. This study aimed to compare the outcomes of open appendectomy (OA) and laparoscopic appendectomy (LA) in overweight and obese patients, shedding light on optimal surgical strategies for this specific patient group.
METHODS: This study scrutinized and compared the outcomes of acute appendicitis treatment using LA and OA methods in overweight and obese patients. Carried out at Bursa Cekirge State Hospital, the study spanned from January 2015 to June 2020. Patient evaluation encompassed demographic characteristics such as age, gender, body mass index (BMI), and American Society of Anesthesiologists (ASA) classification, along with comorbidities, leukocyte count, hemoglobin levels, appendicitis severity, time from symptom onset to surgical intervention, and surgical duration. Surgical outcomes included complications within 30 days, length of hospital stay, pain scores, time to resume work, and complications beyond the initial 30-day post-surgery.
RESULTS: The two groups showed no significant differences in age, gender, BMI, ASA scores, medical history (hypertension, diabetes), leukocyte count, hemoglobin levels, or time to surgery. However, operative time (p<0.001), incision length (p<0.001), and post-operative pain scores (p<0.001) differed significantly. Laparoscopic group had fewer 30-day complications, shorter return to work, and slightly higher satisfaction. Significant differences emerged on the 15th day after surgery. Laparoscopic group had notably better scores in physical function, role, pain, general health (p=0.005, p<0.001, p=0.038, p=0.002). At 1-year milestone, laparoscopic group showed advantages in role and pain (p=0.039, p=0.005).
DISCUSSION AND CONCLUSION: The benefits of LA for obese and overweight patients include shorter surgery durations, reduced infection rates, and faster recovery. These advantages underscore its preference, enhancing patients’ quality of life, and lowering complication risks.