TY - JOUR
T1 - The impact of obesity on laparoscopic appendectomy
T2 - Results from the ACS National Surgical Quality Improvement Program pediatric database
AU - Michailidou, Maria
AU - Sacco Casamassima, Maria G.
AU - Goldstein, Seth D.
AU - Gause, Colin
AU - Karim, Omar
AU - Salazar, Jose H.
AU - Yang, Jingyan
AU - Abdullah, Fizan
PY - 2015/11/1
Y1 - 2015/11/1
N2 - 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 2-18 years 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.
AB - 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 2-18 years 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.
KW - Laparoscopic appendectomy
KW - NSQIP
KW - Obesity
KW - Outcomes
KW - Pediatric
UR - http://www.scopus.com/inward/record.url?scp=84953356419&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84953356419&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2015.07.005
DO - 10.1016/j.jpedsurg.2015.07.005
M3 - Article
C2 - 26255898
AN - SCOPUS:84953356419
VL - 50
SP - 1880
EP - 1884
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 11
ER -