Laparoscopic vs open appendectomy in overweight patients

Enochsson, Lars; Hellberg, Anders; Rudberg, Claes; Fenyö, G; Gudbjartson, Tomas; Kullman, Eric; Ringqvist, Ivar; Sörensen, Stefan; Wenner, Jörgen

doi:10.1007/s004640000334

Cited by 90 publications

(43 citation statements)

References 10 publications

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“…In a recent randomized study, Olsen et al [16] showed that diagnostic laparoscopy in women suspected of acute appendicitis could avoid an unnecessary appendectomy in 30% of the cases. Like others [7,17], we too found that the minimally invasive approach is particularly advantageous in obese patients, those with a known ectopic appendix, and patients with suspected peritonitis.…”

Section: Discussionmentioning

confidence: 98%

The use of laparoscopy in abdominal emergencies

et al. 2003

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Section: Discussionmentioning

confidence: 98%

The use of laparoscopy in abdominal emergencies

et al. 2003

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“…However, using advanced laparoscopic techniques in the surgical armamentarium, the percentage of pre- and postoperative complications decreased [13,14,15]. Over time, laparoscopic interventions have become the first option in obese or overweight patients whose cardiopulmonary functions do not interfere with laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Impact of Increased Body Mass Index on Laparoscopic Surgery for Rectal Cancer

et al. 2011

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Background: Laparoscopy was initially considered to be a risky procedure for rectal cancer patients, especially patients with an increased body weight. The literature is scarce regarding the effects of obesity on laparoscopic rectal surgery. The aim of the current study was to analyze the effect of an increased body mass index (BMI) on outcome of laparoscopic surgery for rectal cancer. Methods: Patients who underwent laparoscopic rectal resection were allocated to one of three groups according to their BMI: normal weight (BMI < 25), overweight (25 ≤ BMI < 30) and obese (BMI ≧ 30). These three groups were compared with each other in terms of patient demographics, postoperative hospital stay, postoperative complications and histopathological data. Results: There were 100 patients operated on for rectal cancer. The median BMI of the patients was 27 (range 18.5–40) kg/m², and 43, 43 and 14 patients were classified as normal weight, overweight and obese, respectively. The conversion rate was 4.7% in the overweight group and 0% in the other groups. The proportion of complications and oncological outcomes between the groups showed no significant difference (p > 0.05). Conclusions: Apparently, increased BMI is not a contraindication for laparoscopic rectal surgery.

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“…In the morbidly obese, longer trocars and instruments may be needed. 4 A meta-analysis of 28 trials available by 1998,4 found that the laparoscopic approach took about 16 minutes longer but resulted in less post-operative pain on day one, shorter hospital stays (15 hours) and quicker return to full activities (5-9 days sooner). Complication rates were comparable, except that wound infections were slightly lower after laparoscopic appendectomy.…”

Section: Post-operative Day Open Appendicectomy Lap Appendicectomymentioning

confidence: 99%

Critical Analysis of the Role of Laparoscopy in Appendicectomy : An Institutional Study

K¹,

Anantharamakrishnan²

2015

jemds

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OBJECTIVE:To evaluate the outcomes of routine open and laparoscopic appendectomy in patients with suspected appendicitis. This is a retrospective study of the outcomes of patients undergoing laparoscopic appendectomy compared with outcomes for patients undergoing open appendectomy during 3year study period. METHODS: It is a retrospective study done in the Department of General Surgery, Chettinad Medical College & Hospital, kelambakkam during the period Jan 2011 -Dec 2013. A total of 100 patients were studied -open (n-50) and laparoscopic procedure (n-50).Results of patients managed with open and laparoscopic procedure for suspected acute appendicitis were reviewed and analyzed. The preoperative and intraoperative findings were recorded. The clinical outcomes were compared in those patients. The various factors like technique of surgery, Duration of surgery, Post-operative morbidity, Analgesic requirement, Antibiotic requirement, Post-operative hospital stay, Complications, Resumption of normal diet, Return to normal activity, Cosmesis were studied. RESULTS: Mean operation time was longer in Lap (45 minutes) as compared to Open (35 minutes).Wound infection regarding skin was seen in 1 patient compared to 3 in open procedure, as the appendix was pulled into the trocar before removing. This maneuver minimizes the chances of wound infection to the skin. 1 Post operative pain and discomfort is less in patients undergoing laparoscopic appendicectomy. Antibiotic and Analgesic requirement was less in Lap group. 2,3 Mean hospital stay was nearly 1/3 rd in Lap group. Better Cosmesis found in Lap group compared to open appendicectomy. Conversion rate was 8% compared to 2 -5 % in literature. 2,3 This is attributed to increase number of complicated cases with adhesions. Post -op complications were seen in 2.5 % of cases compared to 3 -5 % in literature. CONCLUSIONS: We conclude that laparoscopy procedure for suspected acute appendicitis is safe and is associated with a significantly shorter hospital stay. Other intra-abdominal pathologies can also be diagnosed more accurately with the laparoscopic approach.

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Laparoscopic vs open appendectomy in overweight patients

Cited by 90 publications

References 10 publications

The use of laparoscopy in abdominal emergencies

The use of laparoscopy in abdominal emergencies

Impact of Increased Body Mass Index on Laparoscopic Surgery for Rectal Cancer

Critical Analysis of the Role of Laparoscopy in Appendicectomy : An Institutional Study

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