6379
document
Laparoscopic vs open appendectomy in overweight patients . BACKGROUND Laparoscopic appendectomy ( LA ) has been associated with a faster recovery and less postoperative pain than the open technique . However , few data are available on the clinical outcome of LA in overweight patients . METHODS A group of 106 patients with a body mass index ( BMI ) > 26.4 , representing the upper quintile of 500 prospectively randomized patients , were included in the study . They were randomized to undergo either laparoscopic or open appendectomy ( OA ) . Operating and anesthesia times , postoperative pain , complications , hospital stay , functional index ( 1 week postoperatively ) , sick leave , and time to full recovery were documented . RESULTS In OA , the operating time for overweight patients was significantly longer than that for patients in the normal weight range ( 40 vs 35 min , p < 0.05 ) . In LA , there was no difference in operating time between the normal and overweight patients . Overweight patients who underwent LA had longer operating and anesthesia times than their OA counterparts ( 55 vs 40 min , p < 0.001 ; and 125 vs 100 min , p < 0.001 , respectively ) . Postoperative pain was significantly greater in overweight patients who underwent OA than in those treated with the laparoscopic technique . Postoperative pain was also significantly greater in overweight patients subjected to OA than in patients of normal weight after 4 weeks ; the clinical significance may , however , be of less importance since the values are low ( 0.26 vs 0.09 , p < 0.05 ) . There were no significant differences between the two operating techniques in terms of complications . Hospital stay was longer for overweight patients than for normal-weight patients undergoing OA ( 3.0 vs 2.0 , p < 0.01 ) . The functional index did not differ between any group of patients . Sick leave was longer for overweight patients who underwent OA than for normal-weight patients treated with the same technique ( 17 vs 13 days , p < 0.01 ) . In the laparoscopic group , however , there were no differences between the overweight and normal-weight patients . Time to full recovery was greater in overweight patients subjected to OA than in the overweight patients in the LA group ( 22 vs 15 days , p < 0.001 ) . CONCLUSION In this study , overweight patients who were submitted to LA had less postoperative pain and a faster postoperative recovery than overweight patients who had OA . LA also abolished some of the negative effects that overweight had on operating time , hospital stay , and sick leave with the open technique . However , anesthesia and operating times were significantly longer in LA for both overweight patients and those with a normal BMI .
6380
Intervention_Surgical
Laparoscopic
6381
Intervention_Surgical
open appendectomy
6382
Intervention_Surgical
Laparoscopic appendectomy ( LA )
6383
Intervention_Surgical
LA
6384
Intervention_Surgical
laparoscopic or open appendectomy ( OA )
6385
Intervention_Surgical
OA
6386
Intervention_Surgical
LA
6387
Intervention_Surgical
OA
6388
Intervention_Surgical
OA
6389
Intervention_Surgical
laparoscopic technique
6390
Outcome_Other
Operating and anesthesia times
6391
Outcome_Pain
postoperative pain
6392
Outcome_Adverse-effects
complications
6393
Outcome_Other
hospital stay
6394
Outcome_Physical
functional index
6395
Outcome_Other
sick leave
6396
Outcome_Other
time to full recovery
6397
Outcome_Other
operating time
6398
Outcome_Other
operating time
6399
Outcome_Other
operating and anesthesia times
6400
Outcome_Pain
Postoperative pain
6401
Outcome_Pain
Postoperative pain
6402
Outcome_Other
Hospital stay
6403
Outcome_Other
Sick leave
6404
Outcome_Other
Time to full recovery
6405
Outcome_Pain
postoperative pain
6406
Outcome_Other
postoperative recovery
6407
Outcome_Other
operating time
6408
Outcome_Other
hospital stay
6409
Outcome_Other
sick leave
6410
Participant_Condition
overweight
6411
Participant_Sample-size
106