Maria Michailidou1, Maria G Sacco Casamassima1, Seth D Goldstein1, Colin Gause2, Omar Karim1, Jose H Salazar1, Jingyan Yang3, Fizan Abdullah4. 1. Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric, Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. 4. Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago & Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: fa@jhmi.edu.
Abstract
BACKGROUND: Childhood obesity is a worsening epidemic. Little is known about the impact of elevated BMI on perioperative and postoperative complications in children who undergo laparoscopic surgery. The purpose of this study was to examine the effects of obesity on surgical outcomes in children using laparoscopic appendectomy as a model for the broader field of laparoscopic surgery. STUDY DESIGN: Using the Pediatric National Surgical Quality Improvement Program (NSQIP) data from 2012, patients aged 2-18years old with acute uncomplicated and complicated appendicitis who underwent laparoscopic appendectomy were identified. Children with a body mass index (BMI)≥95th percentile for their age and gender were considered obese. Primary outcomes, including overall morbidity and wound complications, were compared between nonobese and obese children. Multivariate regression analysis was conducted to identify the impact of obesity on outcome. RESULTS: A total of 2812 children with acute appendicitis who underwent appendectomy were included in the analysis; 22% were obese. Obese children had longer operative times but did not suffer increased postoperative complications when controlling for confounders (OR 1.3, 95% CI: 0.83-0.072 for overall complications, OR 1.3, 95% CI: 0.84-1.95 for wound complications). CONCLUSIONS: Obesity is not an independent risk factor for postoperative complications following laparoscopic appendectomy. Although operative times are increased in obese children, obesity does not increase the likelihood of 30-day postoperative complications.
BACKGROUND: Childhood obesity is a worsening epidemic. Little is known about the impact of elevated BMI on perioperative and postoperative complications in children who undergo laparoscopic surgery. The purpose of this study was to examine the effects of obesity on surgical outcomes in children using laparoscopic appendectomy as a model for the broader field of laparoscopic surgery. STUDY DESIGN: Using the Pediatric National Surgical Quality Improvement Program (NSQIP) data from 2012, patients aged 2-18years old with acute uncomplicated and complicated appendicitis who underwent laparoscopic appendectomy were identified. Children with a body mass index (BMI)≥95th percentile for their age and gender were considered obese. Primary outcomes, including overall morbidity and wound complications, were compared between nonobese and obesechildren. Multivariate regression analysis was conducted to identify the impact of obesity on outcome. RESULTS: A total of 2812 children with acute appendicitis who underwent appendectomy were included in the analysis; 22% were obese. Obesechildren had longer operative times but did not suffer increased postoperative complications when controlling for confounders (OR 1.3, 95% CI: 0.83-0.072 for overall complications, OR 1.3, 95% CI: 0.84-1.95 for wound complications). CONCLUSIONS:Obesity is not an independent risk factor for postoperative complications following laparoscopic appendectomy. Although operative times are increased in obesechildren, obesity does not increase the likelihood of 30-day postoperative complications.
Authors: Mark A Fleming; Eric W Etchill; Katherine M Marsh; Emmanuel L Abebrese; Ivy Mannoh; Jeffrey W Gander; Alejandro V Garcia; Daniel E Levin Journal: Pediatr Surg Int Date: 2021-10-28 Impact factor: 1.827
Authors: Salomone Di Saverio; Mauro Podda; Belinda De Simone; Marco Ceresoli; Goran Augustin; Alice Gori; Marja Boermeester; Massimo Sartelli; Federico Coccolini; Antonio Tarasconi; Nicola De' Angelis; Dieter G Weber; Matti Tolonen; Arianna Birindelli; Walter Biffl; Ernest E Moore; Michael Kelly; Kjetil Soreide; Jeffry Kashuk; Richard Ten Broek; Carlos Augusto Gomes; Michael Sugrue; Richard Justin Davies; Dimitrios Damaskos; Ari Leppäniemi; Andrew Kirkpatrick; Andrew B Peitzman; Gustavo P Fraga; Ronald V Maier; Raul Coimbra; Massimo Chiarugi; Gabriele Sganga; Adolfo Pisanu; Gian Luigi De' Angelis; Edward Tan; Harry Van Goor; Francesco Pata; Isidoro Di Carlo; Osvaldo Chiara; Andrey Litvin; Fabio C Campanile; Boris Sakakushev; Gia Tomadze; Zaza Demetrashvili; Rifat Latifi; Fakri Abu-Zidan; Oreste Romeo; Helmut Segovia-Lohse; Gianluca Baiocchi; David Costa; Sandro Rizoli; Zsolt J Balogh; Cino Bendinelli; Thomas Scalea; Rao Ivatury; George Velmahos; Roland Andersson; Yoram Kluger; Luca Ansaloni; Fausto Catena Journal: World J Emerg Surg Date: 2020-04-15 Impact factor: 5.469