Comparison of surgical outcomes and quality of life after open vs laparoscopic appendectomy in obese patients
1Dr Hafiz Ahmad Altaf, 2Dr Aroona Arif, 3Muhammad Asghar, 4Dr Muhammad Hamza Hafeez
Submission: 11 January 2026 | Acceptance: 05 February 2026 | Publication: 01 March 2026
1Consultant General surgery, BVH, Bahawalpur
2MS G. Surgery, BVH, BWP
3MBBS,FCPS Surgery, Assistant professor bmdc , BWP
4PGR General Surgery Bvh , Bahawalpur
Abstract
Background: Laparoscopic appendectomy (LA) and open appendectomy (OA) are commonly executed for acute appendicitis. Obesity is a recognized risk factor for postoperative complications; nevertheless, data comparing laparoscopic appendectomy (LA) versus open appendectomy (OA) specifically in obese patients with perforated appendicitis are scarce. The objective of this study was to assess and compare surgical results and postoperative quality of life between laparoscopic-assisted (LA) and open appendectomy (OA) in overweight and obese individuals.
Methods: A prospective comparative clinical study was executed at Bahawal Victoria Hospital, Bahawalpur, from October 2024 to April 2025. Ninety-eight patients with perforated appendicitis and a BMI of 25 kg/m² or more were randomly randomized to either LA (n = 49) or OA (n = 49). We looked at the length of the surgery, the rate of wound infections, the length of the hospital stay, and the recovery period after surgery. Stratified analyses were conducted among BMI categories (overweight: 25–29.99 kg/m²; obese: > 30 kg/m²). We used independent t-tests and Chi-square tests for the statistical analysis, and the level of significance was established at p < 0.05.
Results: The two groups had similar baseline characteristics. The average time for surgery was higher for LA than for OA (76 ± 22 vs 65 ± 16 min; p = 0.02). However, LA was linked to a much shorter hospital stay (4.1 ± 1.1 vs 7.0 ± 1.4 days; p < 0.001) and a reduced rate of wound infections (8.4% vs 22.1%; p = 0.03). LA consistently led to shorter hospital stays and a trend toward less wound infections across all BMI groups, even in obese patients (BMI ≥ 30 kg/m²: 12.0% vs 30.8% for OA; p = 0.081). The LA group had better postoperative recovery and quality of life measures, such as pain, mobility, and getting back to normal activities.
Conclusion: Laparoscopic appendectomy offers considerable benefits over open appendectomy in obese individuals with perforated appendicitis, including expedited recovery, reduced hospital duration, and diminished risk of wound infection, notwithstanding a marginally extended operative time. These results endorse the preferential application of minimally invasive surgery in overweight and obese individuals where technically viable. Additional extensive investigations are need to validate these results across various BMI groups.
Keywords: Laparoscopic appendectomy, open appendectomy, obesity, perforated appendicitis, surgical outcomes, postoperative recovery, wound infection, hospital stay.