Laparoscopic colectomy performed using a completely intracorporeal technique is associated with similar outcome in obese and thin patients.
BACKGROUND
Despite the potential benefits of laparoscopic-assisted colectomy, it is often associated with high operative conversion rates and increased morbidity especially in patients with obesity.


OBJECTIVE
The goal of this study was to evaluate the results of a completely intracorporeal laparoscopic approach in patients including those with obesity.


METHODS
Laparoscopic colectomy was attempted in 85 patients between November 2003 and April 2007. Patients were prospectively followed to determine operative time (OT), blood loss, operative conversion, length of stay, 30 days morbidity, and lymph nodes harvested.


RESULTS
Operative conversion was 2%, mean estimated blood loss was 95+/-84 mL, and mean OT was 220+/-64 minutes. There were no anastomotic leaks or perioperative mortalities. There were 9 major complications (11%). Obese patients (n=25) compared with thin patients (n=58) had similar operative conversion (4% vs. 2%), OT (220+/-73 min vs. 220+65 min), lymph nodes harvested (13+/-6 vs. 11+/-6), major complication rates (16% vs. 9%), and length of stay (5.0+/-2.7 d vs. 4.9+/-1.7 d).


CONCLUSIONS
Laparoscopic colectomy using a completely intracorporeal technique leads to similar surgical results in obese and thin patients.
Blumberg
David
D
Department of Surgery, University of Pittsburgh Medical Center and Bandaid Surgery, Pittsburgh, PA 15232, USA. Davidsurg@aol.com
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003082:Colectomy / Q000379:methods*; D003111:Colonic Polyps / Q000150:complications / Q000601:surgery; D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008223:Lymphoma / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011446:Prospective Studies; D000267:Tissue Adhesions; D016896:Treatment Outcome