Department of Surgery, Keck School of Medicine of the University of Southern California and Los Angeles County-UCS Medical Center, 1200 N State Street Suite 6A231-A, Los Angels, CA 90033, USA.
Surg Endosc. 2011 Apr;25(4):1276-80. doi: 10.1007/s00464-010-1359-5. Epub 2010 Oct 29.
The clinical outcomes for patients randomized to either open or laparoscopic appendectomy are comparable. However, it is not known whether this is true in the subset of the adult population with higher body mass indexes (BMIs). This study aimed to compare the outcomes of open versus laparoscopic appendectomy in the obese population.
A subgroup analysis of a randomized, prospective, double-blind study was conducted at a county academic medical center. Of the 217 randomized patients, 37 had a BMI of 30 kg/m(2) or higher. Open surgery was performed for 14 and laparoscopic surgery for 23 of these patients. The primary outcome measures were the postoperative complication rates. The secondary outcomes were operative time, length of hospital stay, time to resumption of diet, narcotic requirements, and Medical Outcomes Survey Short Form 36 (SF-36) quality-of-life data.
No differences in complications between the open and laparoscopic groups were found. Also, no significant differences were seen in any of the secondary outcomes except for a longer operative time among the obese patients.
In this study, laparoscopic appendectomy did not show a benefit over the open approach for obese patients with appendicitis.
接受开腹或腹腔镜阑尾切除术的患者的临床结局相当。然而，对于 BMI 较高的成年人亚组人群，是否确实如此尚不清楚。本研究旨在比较肥胖人群中开腹与腹腔镜阑尾切除术的结局。
对县学术医疗中心的一项随机、前瞻性、双盲研究进行了亚组分析。在 217 名随机患者中，有 37 名患者的 BMI 为 30 kg/m(2)或更高。其中 14 名患者接受了开腹手术，23 名患者接受了腹腔镜手术。主要观察指标是术后并发症发生率。次要观察指标为手术时间、住院时间、恢复饮食时间、阿片类药物需求以及医疗结局调查短表 36（SF-36）生活质量数据。
开腹组和腹腔镜组的并发症无差异。除肥胖患者的手术时间较长外，其他次要观察指标也无显著差异。
在本研究中，腹腔镜阑尾切除术对于肥胖阑尾炎患者并未显示优于开腹手术。
