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

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)*109 mg/dl), postoperative white blood cell count (9.71 ± 3.91*109 mg/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.