Appendectomy in Patients with Morbid Obesity: Laparoscopic versus Conventional Technique

BACKGROUND: Our aim was to determine the optimum appendectomy technique in patients with morbid obesity by evaluating laparoscopic appendectomy (LA) and open appendectomy (OA) operations performed in these patients. MATERIAL/METHODS: The records of 2179 patients who underwent appendectomy for acute appendicitis between January 2010 and April 2019 were evaluated retrospectively. Patients were excluded for the following: age <18 years; body mass index (BMI) of <40 kg/m(2); perforation and/or plastron detected. The remaining 89 patients were included in the study. The patients were divided into 2 groups: the LA group (n=40) and the OA group (n=49). Demographic data, duration of operation, operation-related wound infection status, operation-related intra-abdominal complication status, operation-related nonsurgical complication status, and length of hospital stay were recorded. RESULTS: No statistically significant difference was found between the 2 groups in terms of age and sex (P=0.062, P=0.078, respectively). However, the average BMI value in the LA group was significantly higher than that of the OA group (P<0.001). Duration of operation and length of hospital stay were significantly lower in the LA group than in the OA group (P<0.001, P<0.001, respectively). General complications and wound infection were significantly lower in the LA group than in the OA group (P=0.012, P=0.031, respectively). CONCLUSIONS: Although LA did not have a clear advantage over OA in patients with morbid obesity, it should be emphasized that laparoscopic surgery may be preferred due to advantages such as a shorter length of hospital stay and lower risk of wound infection.