Impact of Obesity on Surgical Outcomes of Laparoscopic Appendectomy: Lessons Learned From 2000 Cases in an Urban Teaching Hospital

Background: As the prevalence of obesity continues to increase worldwide, we aimed to determine the surgical outcomes of obese patients with acute appendicitis undergoing laparoscopic appendectomy (LA). Materials and Methods: A retrospective analysis of patients undergoing LA during the period 2006 to 2019 was performed. The cohort was divided into 2 groups: G1, patients with body mass index >= 30 kg/m(2) and G2: patients with body mass index < 30 kg/m(2). Results: A total of 2009 LA were performed; 114 (6%) were included in G1 and 1895 (94%) in G2. Complicated acute appendicitis rate (G1: 39% vs. G2: 20%, P< 0.0001), conversion rates (G1: 12% vs. 1.69%, P< 0.0001), overall 30-day morbidity rates (G1: 27% vs. G2: 14%, P= 0.0001), and postoperative intra-abdominal abscess rates (G1: 8% vs. (2%), P< 0.0001) were higher in obese patients. Furthermore, obesity was an independent risk factor for overall morbidity, postoperative intra-abdominal abscess, and conversion to open surgery. Conclusion: In obese patients, LA had inferior clinical outcomes compared with nonobese patients.