Literature DB >> 15621993

The impact of obesity on technical feasibility and postoperative outcomes of laparoscopic left colectomy.

Joel Leroy1, Pascal Ananian, Francesco Rubino, Bertrand Claudon, Didier Mutter, Jacques Marescaux.   

Abstract

OBJECTIVE: To compare technical aspects and postoperative outcomes of laparoscopic left colectomy in obese and nonobese patients. SUMMARY BACKGROUND DATA: Obesity has been generally associated with increased surgical risk. The data regarding outcomes after laparoscopic colectomy in obese and nonobese patients are limited and quite controversial; however, most reports have suggested that obesity is associated with a greater technical difficulty as well as an increased risk for conversions and postoperative complications.
METHODS: All patients undergoing laparoscopic left colectomy for any pathologic condition between January 2001 and January 2003 were analyzed. Patients with a body mass index (BMI) above 30 kg/m were defined as obese and patients with BMI below 30 kg/m were defined as nonobese. Data collected included age, gender, BMI, American Society of Anesthesiologists score, diagnosis, technical parameters of the procedure, operative time, conversion, pathology, length of hospital stay, and complications over a 30-day postoperative course.
RESULTS: A total of 123 patients underwent elective laparoscopic left colectomy during the 2-year period. Twelve patients were excluded from analysis because missing data did not allow calculation of their BMI. Of the 111 patients analyzed, 23 (20.7%) were obese and 88 patients (79.3%) were nonobese. Patients' preoperative clinical characteristics were similar in obese and nonobese patients except for BMI (P > 0.001). There were no significant differences between the 2 groups with respect to intraoperative parameters, duration of the operation, resection margin, and number of harvested nodes as well as overall postoperative complication rates. There were no conversions in the obese patients, whereas 5 procedures in the nonobese group required conversion to open surgery (P = not significant). Obese patients had shorter hospital stays than nonobese subjects (7 +/- 2.5 days vs. 9.5 +/- 7 days; P = 0.018).
CONCLUSION: In contrast with previously reported series of laparoscopic colectomy, our findings show that obesity does not have an adverse impact on the technical difficulty and postoperative outcomes of laparoscopic left colectomy. Our study supports the safety of using laparoscopic surgery for colorectal diseases in obese patients.

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Year:  2005        PMID: 15621993      PMCID: PMC1356848          DOI: 10.1097/01.sla.0000150168.59592.b9

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  17 in total

1.  Elective laparoscopic sigmoid colectomy for diverticulitis. Results of a prospective study.

Authors:  C Smadja; M Sbai Idrissi; M Tahrat; C Vons; E Bobocescu; P Baillet; D Franco
Journal:  Surg Endosc       Date:  1999-07       Impact factor: 4.584

2.  Laparoscopic left colon resection for diverticular disease.

Authors:  G Trebuchet; D Lechaux; J L Lecalve
Journal:  Surg Endosc       Date:  2001-10-13       Impact factor: 4.584

3.  Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes.

Authors:  John Lumley; Russell Stitz; Andrew Stevenson; George Fielding; Andrew Luck
Journal:  Dis Colon Rectum       Date:  2002-07       Impact factor: 4.585

4.  Impact of obesity on surgical outcomes after colorectal resection.

Authors:  S Benoist; Y Panis; A Alves; P Valleur
Journal:  Am J Surg       Date:  2000-04       Impact factor: 2.565

5.  Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs.

Authors:  N T Nguyen; C Goldman; C J Rosenquist; A Arango; C J Cole; S J Lee; B M Wolfe
Journal:  Ann Surg       Date:  2001-09       Impact factor: 12.969

6.  Is obesity a high-risk factor for laparoscopic colorectal surgery?

Authors:  A J Pikarsky; Y Saida; T Yamaguchi; S Martinez; W Chen; E G Weiss; J J Nogueras; S D Wexner
Journal:  Surg Endosc       Date:  2002-02-06       Impact factor: 4.584

7.  Laparoscopic colectomy for sigmoid diverticulitis in obese and nonobese patients: a prospective comparative study.

Authors:  J J Tuech; N Regenet; S Hennekinne; P Pessaux; R Bergamaschi; J P Arnaud
Journal:  Surg Endosc       Date:  2001-12       Impact factor: 4.584

8.  Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results.

Authors:  F Marusch; I Gastinger; C Schneider; H Scheidbach; J Konradt; H P Bruch; L Köhler; E Bärlehner; F Köckerling
Journal:  Surg Endosc       Date:  2001-02       Impact factor: 4.584

9.  COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer.

Authors:  E J Hazebroek
Journal:  Surg Endosc       Date:  2002-03-18       Impact factor: 4.584

10.  Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial.

Authors:  Antonio M Lacy; Juan C García-Valdecasas; Salvadora Delgado; Antoni Castells; Pilar Taurá; Josep M Piqué; Josep Visa
Journal:  Lancet       Date:  2002-06-29       Impact factor: 79.321

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  55 in total

Review 1.  Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis.

Authors:  Yanming Zhou; Lupeng Wu; Xiudong Li; Xiurong Wu; Bin Li
Journal:  Surg Endosc       Date:  2011-10-20       Impact factor: 4.584

2.  Computed tomography volumetric fat parameters versus body mass index for predicting short-term outcomes of colon surgery.

Authors:  Stefano Cecchini; Egildo Cavazzini; Federico Marchesi; Leopoldo Sarli; Luigi Roncoroni
Journal:  World J Surg       Date:  2011-02       Impact factor: 3.352

3.  A totally laparoscopic distal gastrectomy can be an effective way of performing laparoscopic gastrectomy in obese patients (body mass index≥30).

Authors:  Min Gyu Kim; Kap Choong Kim; Beom Su Kim; Tae Hwan Kim; Hee Sung Kim; Jeong Hwan Yook; Byung Sik Kim
Journal:  World J Surg       Date:  2011-06       Impact factor: 3.352

4.  Early results and complications of colorectal laparoscopic surgery and analysis of risk factors in 492 operated cases.

Authors:  Emanuele Santoro; Fabio Carboni; Giuseppe Maria Ettorre; Pasquale Lepiane; Pietro Mancini; Roberto Santoro; Eugenio Santoro
Journal:  Updates Surg       Date:  2010-12

5.  Impact of fat obesity on laparoscopic total mesorectal excision: more reliable indicator than body mass index.

Authors:  Jeonghyun Kang; Song-Ee Baek; Taehyung Kim; Hyuk Hur; Byung Soh Min; Joon Seok Lim; Nam Kyu Kim; Kang Young Lee
Journal:  Int J Colorectal Dis       Date:  2011-11-09       Impact factor: 2.571

6.  Laparoscopic left colectomy and obese patients.

Authors:  Leopoldo Sarli; Renato Costi; Luigi Roncoroni
Journal:  Ann Surg       Date:  2005-11       Impact factor: 12.969

7.  Considerations on the learning curve for laparoscopic colorectal surgery: a view from the bottom.

Authors:  S Leong; R A Cahill; B J Mehigan; R B Stephens
Journal:  Int J Colorectal Dis       Date:  2007-04-03       Impact factor: 2.571

8.  Evaluation of the technical difficulty performing laparoscopic resection of a rectosigmoid carcinoma: visceral fat reflects technical difficulty more accurately than body mass index.

Authors:  Y Seki; M Ohue; M Sekimoto; S Takiguchi; I Takemasa; M Ikeda; H Yamamoto; M Monden
Journal:  Surg Endosc       Date:  2007-02-07       Impact factor: 4.584

9.  Short and long-term outcomes of laparoscopic colectomy in obese patients.

Authors:  Andrea Vignali; Paola De Nardi; Luca Ghirardelli; Saverio Di Palo; Carlo Staudacher
Journal:  World J Gastroenterol       Date:  2013-11-14       Impact factor: 5.742

10.  Effect of Visceral Obesity on Surgical Outcomes of Patients Undergoing Laparoscopic Colorectal Surgery.

Authors:  Byung Kwan Park; Ji Won Park; Seung-Bum Ryoo; Seung-Yong Jeong; Kyu Joo Park; Jae-Gahb Park
Journal:  World J Surg       Date:  2015-09       Impact factor: 3.352

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