Laurent Genser1, Gilles Manceau1, Diane Mege2, Valérie Bridoux3, Zaher Lakkis4, Aurélien Venara5, Thibault Voron6, Thierry Bege7, Igor Sielezneff2, Mehdi Karoui8. 1. Department of Digestive Surgery, Medecine Sorbonne University, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Paris, France. 2. Department of Digestive Surgery, Timone University Hospital, Marseille, France. 3. Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France. 4. Department of Digestive Surgery, Besançon University Hospital, Besançon, France. 5. Department of Digestive Surgery, Angers University Hospital, Angers, France. 6. Department of Digestive Surgery, Medecine Sorbonne University, Assistance Publique Hôpitaux de Paris, Saint Antoine University Hospital, Paris, France. 7. Department of Digestive Surgery, North University Hospital, Marseille, France. 8. Department of Digestive Surgery, Medecine Sorbonne University, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Paris, France, mehdi.karoui@aphp.fr.
Abstract
BACKGROUND: Emergency surgery impairs postoperative outcomes in colorectal cancer patients. No study has assessed the relationship between obesity and postoperative results in this setting. OBJECTIVE: To compare the results of emergency surgery for obstructive colon cancer (OCC) in an obese patient population with those in overweight and normal weight patient groups. METHODS: From 2000 to 2015, patients undergoing emergency surgery for OCC in French surgical centers members of the French National Surgical Association were included. Three groups were defined: normal weight (body mass index [BMI] < 25.0 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obese (BMI ≥30.0 kg/m2). RESULTS: Of 1,241 patients, 329 (26.5%) were overweight and 143 (11.5%) were obese. Obese patients had significantly higher American society of anesthesiologists score, more cardiovascular comorbidity and more hemodynamic instability at presentation. Overall postoperative mortality and morbidity were 8 and 51%, respectively, with no difference between the 3 groups. For obese patients with left-sided OCC, stoma-related complications were significantly increased (8 vs. 5 vs. 15%, p = 0.02). CONCLUSION: Compared with lower BMI patients, obese patients with OCC had a more severe presentation at admission but similar surgical management. Obesity did not increase 30-day postoperative morbidity except stoma-related complications for those with left-sided OCC.
BACKGROUND: Emergency surgery impairs postoperative outcomes in colorectal cancerpatients. No study has assessed the relationship between obesity and postoperative results in this setting. OBJECTIVE: To compare the results of emergency surgery for obstructive colon cancer (OCC) in an obesepatient population with those in overweight and normal weight patient groups. METHODS: From 2000 to 2015, patients undergoing emergency surgery for OCC in French surgical centers members of the French National Surgical Association were included. Three groups were defined: normal weight (body mass index [BMI] < 25.0 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obese (BMI ≥30.0 kg/m2). RESULTS: Of 1,241 patients, 329 (26.5%) were overweight and 143 (11.5%) were obese. Obesepatients had significantly higher American society of anesthesiologists score, more cardiovascular comorbidity and more hemodynamic instability at presentation. Overall postoperative mortality and morbidity were 8 and 51%, respectively, with no difference between the 3 groups. For obesepatients with left-sided OCC, stoma-related complications were significantly increased (8 vs. 5 vs. 15%, p = 0.02). CONCLUSION: Compared with lower BMI patients, obesepatients with OCC had a more severe presentation at admission but similar surgical management. Obesity did not increase 30-day postoperative morbidity except stoma-related complications for those with left-sided OCC.