SynthesisSurgical endoscopy2012
Evidence to support the use of laparoscopic over open appendicectomy for obese individuals: a meta-analysis.
Synthesis in Surgical endoscopy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Impact of Excess Body Weight on Postsurgical Complications.Visceral medicine · 2021Pooled it
- Diagnosis and management of acute appendicitis. EAES consensus development conference 2015.Surgical endoscopy · 2016Guideline
- Laparoscopic appendectomy as the gold standard: What role remains for open surgery, conversion, and disease severity? : An analysis of 32,000 cases with appendicitis in Germany.World journal of emergency surgery : WJES · 2025Observational
- Benefits of laparoscopic liver resection for liver tumors in obese patients: a meta-analysis.Frontiers in oncology · 2024Review
- Diagnostic, Therapy and Complications in Acute Appendicitis of 19,749 Cases Based on Routine Data: A Retrospective Multicenter Observational Study.Journal of clinical medicine · 2022Article
- Appendectomy in Patients with Morbid Obesity: Laparoscopic versus Conventional Technique.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- The Unacceptable Morbidity of Negative Laparoscopic Appendicectomy.World journal of surgery · 2019Article
- Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees.World journal of emergency surgery : WJES · 2019Article
- Prospective Observational Study on acute Appendicitis Worldwide (POSAW).World journal of emergency surgery : WJES · 2018Observational
- Laparoscopic surgery: A qualified systematic review.World journal of methodology · 2015Article
- Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecutive cohort study.Surgical endoscopy · 2015Article
- Laparoscopic revolution in bariatric surgery.World journal of gastroenterology · 2014Review
- Hospital level under-utilization of minimally invasive surgery in the United States: retrospective review.BMJ (Clinical research ed.) · 2014Article
- Is laparoscopic appendectomy safe when performed in a low volume setting?International journal of biomedical science : IJBS · 2014Article
- Review
- Single-incision laparoscopic appendectomy is comparable to conventional laparoscopic and laparotomic appendectomy: our single center single surgeon experience.Il Giornale di chirurgiaArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic appendicectomy (LA) in the obese population has been controversial. A recent SAGES guideline and a Cochrane Review have suggested a benefit for LA over the open approach but did not provide supporting data. This study is the first systematic review and meta-analysis to compare the LA with open surgery in the obese population to provide a quantitative estimate of the relative benefits.
methodsA comprehensive search of the online databases identified seven retrospective and prospective randomized studies that contained sufficient data on obese patients. Analysis was based on intention-to-treat. We calculated pooled odds ratios (ORs) and 95 % confidence intervals using a random-effects model.
resultsThe LA group contained more females (43 vs. 32 %, p < 0.001), had fewer perforations (18 vs. 23 %; p < 0.001), and fewer overall complications (OR: 0.49; 95 % CI: 0.37-0.63), including fewer wound infections (OR: 0.34; 95 % CI: 0.18-0.66). There was no difference in the intra-abdominal abscess rate between the groups (OR: 0.99; 95 % CI: 0.29-3.37). The LA group had a shorter length of stay (2.46 vs. 3.63 days; p < 0.001) but a longer operation time (96 vs. 78 min, p < 0.001). There was no heterogeneity between the studies.
conclusionsThis meta-analysis of the current published data establishes the laparoscopic approach to appendicectomy as the preferred technique for the obese population, delivering a 50 % reduction in morbidity, with a 66 % reduction in wound infections and a significantly shorter inpatient hospital stay without increasing the intra-abdominal abscess rate.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.