A comparison of laparoscopic versus open appendectomy for overweight patients in Bangkok Metropolitan Administration General Hospital: a retrospective study
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Abstract
Objectives: To compare the result of appendicitis treatment between laparoscopic surgery (LA) and open surgery (OA) in overweight patient. In term of hospital length of stay (LOS), intraoperative time, time to resume diet and postoperative complications.
Methods: A retrospective study by reviewing medical records of overweight patients (BMI ≥ 23 kg/m2) in Bangkok Metropolitan Administration General Hospital with acute appendicitis who underwent LA and OA from January 2012 through December 2017. The data included personal information, intraoperative details, postoperative details and the data of those was analyzed and was compared between open and laparoscopic surgery.
Results: There were 136 (71 male, 65 female) overweight patients underwent appendectomy. Subjects were divided into 2 groups; 68 in LA and 68 in OA. Median length of stay (LOS) for LA was better, 58.5 hours versus 85.5 hours for OA (P < 0.01), median operative blood loss for LA was better, 5 ml versus 20 ml for OA (P < 0.01) and primary wound closure rate was better, 100% for LA versus 85% for OA (P = 0.001). Other outcome measures were equivalent.
Conclusion: LA can be performed safely with shorter LOS, less delayed primary wound closure and less operative blood loss in overweight patients and should be considered the procedure of choice for overweight patients with appendicitis.
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References
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