Laparoscopic appendectomy in obese patients - experience from small, general hospital

Abstract

Background: Acute appendicitis (AA) is the most common cause of acute abdominal pain in the general population. In the past 30 years, obesity has become twice as common. Emergency surgery services are more often faced with obese patients with acute abdominal pain whose origin is AA. That is why we wanted to compare our results with data from the literature on laparoscopic surgery of obese patients with AA.
Materials and methods: This is a retrospective study, which includes the population of obese patients who underwent surgery at our facility during the period from 1.1.2018. to 31.12.2022. Data were taken from our patients’ electronic records. Patients were included in the study who had body mass index (BMI) 30 and more, without any serious comorbidity. Exclusion criteria were: younger than 20 years, previous laparotomy, periappendicular infiltration, unregulated hypertension and diabetes mellitus, and morbidity obesity (BMI 40 and above). We analyzed demographic data, the length of surgery, PH findings of appendicitis, consumption of analgesics, beginning of peristalsis, length of stay and postoperative complications.
Results: In the period in question the laparoscopic approach was used in surgery on 190 patients in the treatment of AA. 20 obese patients (10.52%) were included in our study. There were 11 male and 9 female patients, whose average age was 42 years. The duration of the operation was 55 minutes, the most frequent PH finding was phlegmonous inflammation of the appendix in 12 patients. The appearance of peristalsis was on the first postoperative day, consumption of analgesics was two ampullas of metamizole on the day of the operation. The length of stay was 3 days, and there were two abscesses as postoperative complications.
Conclusion: The laparoscopic approach has many advantages that are even greater in the obese population in relation to those of normal weight. The operation takes less time, postoperative pain is reduced, recovery after laparoscopic appendectomy is faster, and there are fewer postoperative complications. This approach should be used more often.