Tomoki Makino1, Koiana Trencheva2, Parul J Shukla2, Francesco Rubino3, Changhua Zhuo4, Raghava S Pavoor2, Jeffrey W Milsom5. 1. Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. 2. Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY. 3. Division of Metabolic Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY. 4. Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY; Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. 5. Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY. Electronic address: mim2035@med.cornell.edu.
Abstract
BACKGROUND: Despite the increasing prevalence of obesity and colonic diseases, the impact of obesity on short-term and oncologic outcomes of laparoscopic colorectal surgery still remains unclear. STUDY DESIGN: Seventy-six consecutive obese patients with body mass index (BMI) ≥30 kg/m(2) who underwent laparoscopic colectomy were matched with 76 nonobese patients with BMI <30 kg/m(2). Perioperative parameters and oncologic outcomes were analyzed in the two groups. RESULTS: Obesity was associated with greater operative time (obese vs nonobese, 182 ± 59 vs 157 ± 55 min, P = .0084) and multivariate analysis identified BMI (hazard ratio 2.11, 95% confidence interval 0.64-3.56, P = .0049) as an independent predicting factor for operative time together with cancer location (hazard ratio 28.6, 95% confidence interval 14.62-42.51, P < .0001). Obesity had no adverse influence on overall morbidity (25 vs 21%, P = .563), however, or postoperative duration of stay (median 6.0 vs 5.5 days, P = .22). Furthermore, the rate of conversion to open procedure was similar between the two groups (9 vs 9%, P > .99). Regarding oncologic outcomes, there was no statistical difference in overall and disease-free survival between the two groups (5-year overall survival rate 86 vs 89%, P = .72, 5-year disease survival rate 70 vs 77%, P = .70). CONCLUSION: Laparoscopic colonic resection, when performed for selected patients, appears to be a safe and reasonable option in obese patients with colon cancer resulting in similar short-term and oncologic outcomes as nonobese patients.
BACKGROUND: Despite the increasing prevalence of obesity and colonic diseases, the impact of obesity on short-term and oncologic outcomes of laparoscopic colorectal surgery still remains unclear. STUDY DESIGN: Seventy-six consecutive obesepatients with body mass index (BMI) ≥30 kg/m(2) who underwent laparoscopic colectomy were matched with 76 nonobese patients with BMI <30 kg/m(2). Perioperative parameters and oncologic outcomes were analyzed in the two groups. RESULTS:Obesity was associated with greater operative time (obese vs nonobese, 182 ± 59 vs 157 ± 55 min, P = .0084) and multivariate analysis identified BMI (hazard ratio 2.11, 95% confidence interval 0.64-3.56, P = .0049) as an independent predicting factor for operative time together with cancer location (hazard ratio 28.6, 95% confidence interval 14.62-42.51, P < .0001). Obesity had no adverse influence on overall morbidity (25 vs 21%, P = .563), however, or postoperative duration of stay (median 6.0 vs 5.5 days, P = .22). Furthermore, the rate of conversion to open procedure was similar between the two groups (9 vs 9%, P > .99). Regarding oncologic outcomes, there was no statistical difference in overall and disease-free survival between the two groups (5-year overall survival rate 86 vs 89%, P = .72, 5-year disease survival rate 70 vs 77%, P = .70). CONCLUSION: Laparoscopic colonic resection, when performed for selected patients, appears to be a safe and reasonable option in obesepatients with colon cancer resulting in similar short-term and oncologic outcomes as nonobese patients.
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