Obesity: is there an increase in perioperative complications in those undergoing elective colon and rectal resection for carcinoma?
The hypothesis of this study was that obese and overweight patients undergoing elective resection for colon and rectal cancer have longer operative times, increased intraoperative blood loss, and more postoperative complications compared with normal-weight individuals. Our study cohorts included all patients undergoing elective first-time colon resection for proven colorectal carcinoma. Patients undergoing resection for recurrent disease or for emergent indications such as obstruction, perforation, or hemorrhage and those who underwent an additional surgical procedure at the time of colon resection were excluded from analysis. We conducted a retrospective chart review of all patients undergoing resection for colorectal carcinoma during a 30-month period. One hundred fifty-three consecutive patients were identified. Body Mass Index was calculated for each patient. Each patient was labeled as normal, overweight, or obese on the basis of World Health Organization criteria. Estimated intraoperative blood loss, duration of surgery, and postoperative complications were recorded for each patient. Comparisons of continuous variables were made using one- or two-way analysis of variance testing. Comparisons of discrete variables were made with chi-square testing. Level of confidence was defined as P < 0.05. Forty-eight normal, 54 overweight, and 51 obese patients were identified. The type of colon resection, age range, and premorbid conditions were well matched between groups. There was no statistical difference in intraoperative blood loss between groups. The operative times were statistically longer in obese and overweight groups compared with the normal group. No statistical differences existed in postoperative complications between groups. We conclude that obese and overweight patients undergoing resection for colorectal carcinoma when compared with normal-weight patients have similar intraoperative blood loss and postoperative complications but longer operative times.
Blee
Thomas H
TH
Department of Surgery, Gundersen Lutheran Medical Center, LaCrosse, Wisconsin 54601, USA.
Belzer
G Eric
GE
Lambert
Pamela J
PJ
D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000601:surgery*; D015897:Comorbidity; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies