Comparison Of Laparoscopic Versus Open Appendectomy In The Obese Population

Purpose Compare the laparoscopic appendectomy with open appendectomy in obese patients in terms of therapeutic effect and hospitalization costs. Methods Retrospective analysis the cases of obese patients with acute appendicitis who underwent operation between January 2014 and December 2015 in China Japan Union Hospital Of JiLin university. Obesity is defined as BMI(Body Mass Index,BMI)≥ 25 kg / ㎡. According to the surgical way divided the patients into laparoscopic appendectomy(LA) group and open appendectomy(OA) group. Retrospectively analyzed the clinical data of two groups. Compare duration of operation, the length of hospital stay, the hospitalization costs and postoperative complications etc of the two groups. Results 77 of the cases meet the inclusion criteria for the research. Among them, 41 patients underwent laparoscopic appendectomy; 36 cases underwent open appendectomy. ○1 Compare to the OA group(94.81 ± 40.72min), LA group(66.9 ± 25.47min) used less operation duration, the difference was statistically significant(p = 0.000).○2 LA group bowel function recovery time(25.05 ± 4.17h) was significantly less than the OA group(37.83 ± 7.68h), the difference was statistically significant(p = 0.000).○3 In terms of the length of hospital stay, LA group(5.4 ± 2.2 days) was significantly shorter than the OA group(8.3 ± 4.9 days), the difference was statistically significant(p = 0.003). ○4 In terms of hospitalization costs, LA group(16923.60 ± 4824.31) and OA group(20988.88 ± 11729.62 million) was no significant difference(p = 0.059).○5 Postoperative complications : LA group was no incision infection case, OA group surgical wound infection rate was 19.44%, the difference of surgical wound infection rate between the two groups was statistically significant(p = 0.003); In terms of the tntraabdominal abscess rate, LA group was 2.44%, OA group was 5.56%, the difference was not statistically significant(p = 0.908); LA group ileus incidence was 2.44%, OA were no cases of ileus, ileus incidence between the two groups was not statistically significant on(p = 1.000); There were no other surgery-related complications in both of two groups; The incidence of totall postoperative complications LA group(4.88%) was significantly less than OA group(25.00%), the difference was statistically significant(p = 0.028). Conclusion Obese patients with acute appendicitis undergo laparoscopic appendectomy have shorter duration of operation, fewer postoperative complications, quicker recovery, without increasing hospitalization costs, compared with open appendectomy have significant advantages, it is worth extensive.