{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:59Z","timestamp":1789448579551,"version":"build-2803163510"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the association between stratified body mass index (BMI) and the intraoperative outcomes and short-term postoperative recovery profiles of patients undergoing single-incision laparoscopic appendectomy (SILA), utilizing a propensity score-matched (PSM) analysis to minimize baseline selection bias and confounding clinical factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data of 282 patients who underwent SILA between January 2024 and January 2026 were retrospectively analyzed, comprising 93 patients in the normal weight group, 97 in the overweight group, and 92 in the obesity group. To control for baseline confounding, a 1:1 nearest-neighbor PSM with a strict caliper of 0.02 was performed based on preoperative covariates, including age, gender, comorbidities, history of abdominal surgery, preoperative delay, and pathological diagnosis. Intraoperative parameters and postoperative recovery profiles were subsequently compared among the matched groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 1:1 propensity score matching, a well-balanced cohort was successfully analyzed, with all preoperative baseline variables closely aligned (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). In the matched cohort, appendiceal length and width showed no statistical differences among the stratified groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Importantly, no patients required conversion to open surgery. However, higher BMI was associated with a stepwise prolongation of operative time (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) and greater intraoperative blood loss (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Postoperatively, the time to first flatus was longer in patients with higher BMI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Furthermore, higher BMI was associated with elevated postoperative pain scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and a higher incidence of gastrointestinal adverse reactions, including nausea\/vomiting (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008), abdominal distension (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), and diarrhea (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While single-incision laparoscopic appendectomy remains safe and technically feasible, an elevated BMI was associated with impaired operative efficiency, more intense early postoperative pain, and slower short-term gastrointestinal recovery. Clinicians should fully weigh these hidden recovery costs and metabolic stress profiles during perioperative management for overweight and obese patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1903116","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:17Z","timestamp":1789446437000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of body mass index on perioperative outcomes and short-term recovery profiles of single-incision laparoscopic appendectomy: a propensity score-matched analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Dake","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehua","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbin","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1007\/s00464-009-0563-7","article-title":"Laparoscopic versus open appendectomy: a prospective randomized comparison","volume":"24","author":"Wei","year":"2010","journal-title":"Surg Endosc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12893-023-02108-1","article-title":"Comparison of the efficacy and safety of antibiotic treatment and appendectomy for acute uncomplicated appendicitis: a systematic review and meta-analysis","volume":"23","author":"Xu","year":"2023","journal-title":"BMC Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.jss.2023.01.004","article-title":"Operative management of acute appendicitis was safe during the COVID-19 pandemic shutdown","volume":"287","author":"Cheng","year":"2023","journal-title":"J Surg Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"5508","DOI":"10.1007\/s00464-026-12891-6","article-title":"Laparoscopic appendectomy for complicated appendicitis with periappendiceal abscess versus without abscess in children: a prospective cohort study","volume":"40","author":"Wang","year":"2026","journal-title":"Surg Endosc"},{"key":"B5","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1097\/SLE.0000000000000877","article-title":"Easily applicable single-incision laparoscopic appendectomy using straightforward instrumental alignment and conventional laparoscopic instruments","volume":"31","author":"Chong","year":"2020","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B6","doi-asserted-by":"publisher","first-page":"CD009022","DOI":"10.1002\/14651858.CD009022.pub4","article-title":"Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis","volume":"9","author":"Irfan","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1007\/s00464-023-10659-w","article-title":"Laparoscopic appendectomy with single port vs conventional access: systematic review and meta-analysis of randomized clinical trials","volume":"38","author":"Cirocchi","year":"2024","journal-title":"Surg Endosc"},{"key":"B8","doi-asserted-by":"publisher","first-page":"7544","DOI":"10.1007\/s00464-024-11260-5","article-title":"Concurrent minimally invasive bariatric surgery and ventral hernia repair with mesh; is it safe? 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