Open–close case? New data on appendectomy in an obese patient cohort

Mason, Rodney J.; Mason, Ashley J

doi:10.1586/egh.12.62

Cited by 5 publications

(3 citation statements)

References 8 publications

(13 reference statements)

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“…Furthermore, we also found that obesity was associated with significantly prolonged length of hospital stays in patients who had undergone open appendectomy, rather than in case of laparoscopic appendectomy. We conclude, therefore, that laparoscopic appendectomy is more favorable for obese pediatric patients than open appendectomy, as has been reported for obese adults and children [ 6 , 14 , 15 ]. Mason et al postulated that the advantage of the laparoscopic technique in obese patients is entirely due to wound and wound-related complications [ 23 ].…”

Section: Discussionsupporting

confidence: 79%

“…The influence of BMI on the outcome of these two types of appendectomy is still under debate. Several studies demonstrated that a laparoscopic appendectomy associates with better outcomes in both obese children and adults in the sense of fewer complications and shorter hospital stays [ 6 , 14 , 15 ], while other studies reported no additional benefit from laparoscopy for obese patients compared to non-obese patients [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children

Timmerman

Groen

Heineman

et al. 2016

Int J Colorectal Dis

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PurposeThe impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children.MethodsThe correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retrospective analysis of 457 children diagnosed with appendicitis. Based on BMI percentiles, patients were classified as either underweight (n = 36), normal weight (n = 346), overweight (n = 59), or obese (n = 16). Diagnosis accuracy was measured by negative appendectomy rate, perforation rate, and number of consultations. Treatment quality was measured by complication rate and length of hospital stay.ResultsUnderweight patients had the highest negative appendectomy (OR 3.00, P = 0.008) and complication (OR 2.75, P = 0.041) rate. BMI did not influence perforation rate or number of consultations. Both underweight and obese patients stayed in the hospital longer than normal weight patients (regression coefficient 2.34, P = 0.001, and regression coefficient 9.40, P < 0.001, respectively).Furthermore, in obese patients, the hospital stay after open appendectomy was prolonged compared to laparoscopic appendectomy (P < 0.001). No such differences were observed in patients with lower BMI.ConclusionsUnderweight children are misdiagnosed more often, stay in hospital longer, and experience more postoperative complications than children of normal weight. Obesity is associated with longer hospital stays. Laparoscopic appendectomy might shorten the length of hospital stays in these patients. We conclude that in addition to obesity, underweight should also be considered a risk factor for children with appendicitis.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children

Timmerman

Groen

Heineman

et al. 2016

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

“…Riscul anestezic asociat este mult mai mare, necesitând o pregătire preoperatorie mai laborioasă [3]. Din punct de vedere chirurgical, în cazul pacienţilor obezi, manevrele operatorii sunt mult îngreunate de grosimea peretelui abdominal care necesită incizii mai largi în chirurgia deschisă și de volumul mare de grăsime peritoneală care acoperă câmpul operator [4]. Aceste impedimente au determinat în chirurgia laparoscopică di cultăţi în introducerea primului trocar, insu area pneumoperitoneului, ventilaţia pacientului după poziţionarea în Trendelenburg și vizualizarea îngreunată de grăsimea epiploică [5,6].…”

Section: Introducereunclassified