Laparoscopic versus open appendectomy in obese patients: A meta-analysis of prospective and retrospective studies

被引:22
作者
Ciarrocchi, Andrea [1 ]
Amicucci, Gianfranco [1 ]
机构
[1] Univ Aquila, Dept Gen & Emergency Surg, I-67100 Laquila, Italy
关键词
Acute appendicitis; laparoscopic appendectomy; obesity; open appendectomy; APPENDICITIS;
D O I
10.4103/0972-9941.124451
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: A meta-analysis of different kinds of studies was performed to assess outcomes of laparoscopic versus open appendectomy in obese patients. Materials and Methods: Retrospective and prospective studies enrolling patients with a body mass index greater than 30 kg/m (2) were included. Primary outcomes were days of hospital stay, surgical procedure duration, and overall post-operative complication rate. Secondary outcomes were wound infection and intra-abdominal abscesses formation rate, hospital charges. Results: Laparoscopic appendectomy showed to be significantly associated with lower wound infection (P < 0.001) and post-operative complication rate (P < 0.001). Surgical time was considered as a hallmark of technical challenge and resulted diminished in the laparoscopic group (P = 0.018). Although not clinically relevant per se, the statistically significant shorter hospital stay (P < 0.001) was probably the reason of decreased hospital charges (P < 0.001). Intra-abdominal abscesses formation rate was higher in the open appendectomy group (P = 0.058), although slightly above the statistical significance threshold. Conclusion: Laparoscopic approach seemed to show relevant advantages compared to open appendectomy, but a large prospective trial is necessary to collect high quality data and investigate long-term outcomes.
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页码:4 / 9
页数:6
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