Impact of visceral obesity on the short-term outcomes after laparoscopic appendectomy

Abstract

Objective

To investigate the effect of visceral obesity on short-term outcomes after laparoscopic appendectomy (LA).

Methods

a retrospective study on 441 patients who underwent a LA between July 2019 and July 2020. According to the cutoff visceral fat area (VFA) for visceral obesity, the patients were divided into two groups: visceral obesity group (n = 123) and non-visceral obesity group (n = 318). The general information, comorbidities, perioperative monitoring indicators, and postoperative complications of the patients were collected.

Results

Compared with the non-visceral obesity group, the proportion of overweight patients (56.10%), preoperative white blood cell count (12.92 (9.99, 15.58)*10⁹mg/dl), postoperative white blood cell count (9.71 ± 3.91*10⁹mg/dl), and hospitalization costs (16,220.93 ± 7038.76¥) in the visceral obesity group were significantly different (all p < 0.05). Additionally, multivariate logistic regression analysis revealed that visceral obesity (2.679, 95%CI: 1.155–5.849, p = 0.027), indwelling drainage tube (7.832, 95%CI: 2.151–27.428, p < 0.001), and perforated appendicitis (3.181, 95%CI: 1.195–7.136, p = 0.025) were identified to be independent risk factors for incision infection after LA. The area under receiver operating characteristic (ROC) curve value for VFA predicting incisional infection after LA was 0.770.

Conclusions

Visceral obesity is one of the independent risk factors for incisional infection after LA, and can be used as one of the reference indicators for prognostic assessment of short-term outcomes after LA.

Keywords:

• Laparoscopic appendectomy
• visceral obesity
• postoperative complications
• incision infection

Acknowledgments

The authors thank everyone participating in the clinical and laboratory work.

Ethical approval

This study was approved by the Ethics Committee (Institutional Review Board) of the Second Affiliated Hospital of Wenzhou Medical University and informed written consent was obtained from all participants (2021-K-74-09).

Author’s contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Kui Chen and Liangliang Ma. Formal analysis and investigation were performed by Hao Pan. The first draft of the manuscript was written by Liangliang Ma. The Writing - review and editing were performed by Kui Chen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.

Data availability statement

The datasets analysed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was funded by basic scientific research projects in Wenzhou, Zhejiang, China [No. Y2020049]. The Funder had no role in the design, conduct or interpretation of the study. The open access publication fee is paid by the funder.