Laparoscopic versus open appendicectomy in obese patients: a prospective randomized comparison

Background Obese patients who present with general surgical emergencies afford unique obstacles to emergency surgeons. Whereas there seems to be no absolute advantage to laparoscopy in acute appendicitis for the overall population, it has been postulated that among obese cases, the laparoscopic technique may provide more conclusive benefits. Objectives Because of limited data on this issue, the focus of this research was to compare the clinical outcomes of laparoscopic and open-appendicectomy techniques in obese population. Patients and methods A number of 64 cases of acute appendicitis with BMI more than or equal to 30 were randomly assigned to one of two groups: laparoscopic or open-appendicectomy groups. The outcomes evaluated include duration of hospital stay, operative times, postoperative complications comprising intra-abdominal abscesses and incision-site infections, time to start oral intake, and number of analgesic-dose requirements. Results In comparison with open appendicectomy, laparoscopic appendicectomy associated with shorter operative time P value of 0.042, shorter length of hospital stay (P=0.001), fewer doses of analgesia (P<0.001), and earlier toleration of oral intake (P=0.002). While there was nonsignificant difference between the groups for intraoperative complications (P=0.565) or postoperative complications (intra-abdominal or surgical-site complications) (P=0.708). Conclusion Laparoscopic appendectomy resulted in lower operative time, a shorter hospital stay, earlier oral intake, and a reduced need for analgesia with a complication rate that was comparable to its open counterpart, and it can be recommended as a standard procedure in obese patients with acute appendicitis.