Impact of Obesity on Surgical Outcomes of Laparoscopic Appendectomy: Lessons Learned From 2000 Cases in an Urban Teaching Hospital.

BACKGROUND As the prevalence of obesity continues to increase worldwide, we aimed to determine the surgical outcomes of obese patients with acute appendicitis undergoing laparoscopic appendectomy (LA). MATERIALS AND METHODS A retrospective analysis of patients undergoing LA during the period 2006 to 2019 was performed. The cohort was divided into 2 groups: G1, patients with body mass index ≥30 kg/m2 and G2: patients with body mass index <30 kg/m2. RESULTS A total of 2009 LA were performed; 114 (6%) were included in G1 and 1895 (94%) in G2. Complicated acute appendicitis rate (G1: 39% vs. G2: 20%, P<0.0001), conversion rates (G1: 12% vs. 1.69%, P<0.0001), overall 30-day morbidity rates (G1: 27% vs. G2: 14%, P=0.0001), and postoperative intra-abdominal abscess rates (G1: 8% vs. (2%), P<0.0001) were higher in obese patients. Furthermore, obesity was an independent risk factor for overall morbidity, postoperative intra-abdominal abscess, and conversion to open surgery. CONCLUSION In obese patients, LA had inferior clinical outcomes compared with nonobese patients.