Right hemicolectomy did not seem to confer any survival advantage on patients with appendiceal carcinoids with a diameter >2 cm. For this reason, tumor size should not be considered an absolute indication for right hemicolectomy.

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/m2 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.

Based on the data retrieved from the SEER database, metastasis to loco-regional lymph nodes is an important prognostic factor, but lymphadenectomy does not improve survival.

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