Youri Q M Poelemeijer1, Niki Lijftogt2, Robin Detering3, Marta Fiocco4, Rob A E M Tollenaar5, Michel W J M Wouters6. 1. Department of Surgery, Leiden University Medical Center, Leiden, Netherlands; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands. Electronic address: y.q.m.poelemeijer@lumc.nl. 2. Department of Surgery, Leiden University Medical Center, Leiden, Netherlands. 3. Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands; Department of Surgery, Academic Medical Center, Amsterdam, Netherlands. 4. Medical Statistics and Bioinformatics Department, Leiden University Medical Center, Leiden, Netherlands. 5. Department of Surgery, Leiden University Medical Center, Leiden, Netherlands; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands. 6. Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands; Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands.
Abstract
BACKGROUND: Obesity is an increasing problem worldwide that can influence perioperative and postoperative outcomes. However, the relationship between obesity and treatment-related perioperative and short-term postoperative morbidity after colorectal resections is still subject to debate. STUDY: Patients were selected from the DCRA, a population-based audit including 83 hospitals performing colorectal cancer (CRC) surgery. Data regarding primary resections between 2009 and 2016 were eligible for analyses. Patients were subdivided into six categories: underweight, normal weight, overweight and obesity class I, II and III. RESULTS: Of 71,084 patients, 17.7% with colon and 16.4% with rectal cancer were categorized as obese. Significant differences were found for the 30-day overall postoperative complication rate (p < 0.001), prolonged hospitalization (p < 0.001) and readmission rate (colon cancer p < 0.005; rectal cancer p < 0.002) in obese CRC patients. Multivariate analysis identified BMI ≥30 kg/m2 as independent predictor of a complicated postoperative course in CRC patients. Furthermore, obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate. No significant differences in performance were observed in postoperative outcomes of morbidly obese CRC patients between hospitals performing bariatric surgery and hospitals that did not. CONCLUSION: The real-life data analysed in this study reflect daily practice in the Netherlands and identify obesity as a significant risk factor in CRC patients. Obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate in obese CRC patients. No differences were observed between hospitals performing bariatric surgery and hospitals that did not.
BACKGROUND:Obesity is an increasing problem worldwide that can influence perioperative and postoperative outcomes. However, the relationship between obesity and treatment-related perioperative and short-term postoperative morbidity after colorectal resections is still subject to debate. STUDY: Patients were selected from the DCRA, a population-based audit including 83 hospitals performing colorectal cancer (CRC) surgery. Data regarding primary resections between 2009 and 2016 were eligible for analyses. Patients were subdivided into six categories: underweight, normal weight, overweight and obesity class I, II and III. RESULTS: Of 71,084 patients, 17.7% with colon and 16.4% with rectal cancer were categorized as obese. Significant differences were found for the 30-day overall postoperative complication rate (p < 0.001), prolonged hospitalization (p < 0.001) and readmission rate (colon cancer p < 0.005; rectal cancer p < 0.002) in obese CRC patients. Multivariate analysis identified BMI ≥30 kg/m2 as independent predictor of a complicated postoperative course in CRC patients. Furthermore, obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate. No significant differences in performance were observed in postoperative outcomes of morbidly obese CRC patients between hospitals performing bariatric surgery and hospitals that did not. CONCLUSION: The real-life data analysed in this study reflect daily practice in the Netherlands and identify obesity as a significant risk factor in CRC patients. Obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate in obese CRC patients. No differences were observed between hospitals performing bariatric surgery and hospitals that did not.
Authors: Stéphanie M L M Looijaard; Carel G M Meskers; Monique S Slee-Valentijn; Donald E Bouman; A N Machteld Wymenga; Joost M Klaase; Andrea B Maier Journal: Oncologist Date: 2019-11-20
Authors: Stéphanie M L M Looijaard; Carel G M Meskers; Monique S Slee-Valentijn; Donald E Bouman; A N Machteld Wymenga; Joost M Klaase; Andrea B Maier Journal: Oncologist Date: 2019-11-20
Authors: Melissa N N Arron; Richard P G Ten Broek; Carleen M E M Adriaansens; Stijn Bluiminck; Bob J van Wely; Floris T J Ferenschild; Henk F M Smits; Harry van Goor; Johannes H W de Wilt; André S van Petersen Journal: Int J Colorectal Dis Date: 2022-01-07 Impact factor: 2.571