INTRODUCTION: There have been several series documenting the utility of single-site laparoscopic appendectomy. However, there are no data to support patient selection based on their physical characteristics. We recently completed a large prospective, randomized trial comparing single-site laparoscopic appendectomy with standard three-port laparoscopic appendectomy for nonperforated appendicitis. This dataset was used to examine the relative impact of body habitus on operative approach. SUBJECTS AND METHODS: We performed an analysis of the dataset collected in a prospective, randomized trial of 360 appendectomy patients who presented with nonperforated appendicitis. Body mass index (BMI) was calculated and plotted on a growth chart to obtain BMI percentile according to gender and age. Standard definitions for overweight (BMI 85-95%) and obesity (BMI >95%) were used. RESULTS: In the single-site group there were 26 overweight and 19 obese patients. In the three-port group there were 25 overweight and 16 obese patients. There were no significant differences between overweight and normal with either approach. However, with the single-site approach there was longer mean operative time, more doses of postoperative narcotics given, longer length of stay, and greater hospital charges in obese patients. In the three-port group, there were no differences between normal and obese patients. CONCLUSIONS: When using the single-site approach for appendectomy, obesity in children creates longer operative times, more doses of postoperative analgesics, longer length of stay, and greater charges. However, obesity has no impact on three-port appendectomy.
RCT Entities:
INTRODUCTION: There have been several series documenting the utility of single-site laparoscopic appendectomy. However, there are no data to support patient selection based on their physical characteristics. We recently completed a large prospective, randomized trial comparing single-site laparoscopic appendectomy with standard three-port laparoscopic appendectomy for nonperforated appendicitis. This dataset was used to examine the relative impact of body habitus on operative approach. SUBJECTS AND METHODS: We performed an analysis of the dataset collected in a prospective, randomized trial of 360 appendectomy patients who presented with nonperforated appendicitis. Body mass index (BMI) was calculated and plotted on a growth chart to obtain BMI percentile according to gender and age. Standard definitions for overweight (BMI 85-95%) and obesity (BMI >95%) were used. RESULTS: In the single-site group there were 26 overweight and 19 obesepatients. In the three-port group there were 25 overweight and 16 obesepatients. There were no significant differences between overweight and normal with either approach. However, with the single-site approach there was longer mean operative time, more doses of postoperative narcotics given, longer length of stay, and greater hospital charges in obesepatients. In the three-port group, there were no differences between normal and obesepatients. CONCLUSIONS: When using the single-site approach for appendectomy, obesity in children creates longer operative times, more doses of postoperative analgesics, longer length of stay, and greater charges. However, obesity has no impact on three-port appendectomy.
Authors: Michael Clerveus; Antonio Morandeira-Rivas; Carlos Moreno-Sanz; Maria Luz Herrero-Bogajo; Joaquin Salvelio Picazo-Yeste; Gloria Tadeo-Ruiz Journal: World J Surg Date: 2014-08 Impact factor: 3.352
Authors: Franziska Köhler; Lena Reese; Carolin Kastner; Anne Hendricks; Sophie Müller; Johan F Lock; Christoph-Thomas Germer; Armin Wiegering Journal: Front Surg Date: 2022-06-08