Laparoscopic colorectal cancer surgery in obese patients.
OBJECTIVE
The aim of this study was to assess the oncological and postoperative outcomes of laparoscopic colorectal cancer surgery in obese patients.


METHODS
All obese (BMI > 30) patients who underwent laparoscopic colorectal cancer surgery from January 2005 to January 2008 were compared with nonobese patients undergoing similar surgery. We recorded patient demographics, intra-operative details and postoperative morbidity and mortality.


RESULTS
Sixty-two obese and 172 nonobese patients underwent laparoscopic colorectal cancer resection. Both groups were well matched for demographic parameters. Overall mean operating times were not significantly different. Conversion to open surgery was more likely in obese patients. In particular, for rectal cancers, the conversion rate was 44% in the obese group compared with 17% in the nonobese group (P < 0.05). Postoperative morbidity was also greater in obese patients (P < 0.05). The duration of hospital stay was similar for laparoscopically completed cases (6 days obese vs 7 days nonobese), but in the obese-converted group it was 14 days (P < 0.05). The resected specimen with respect to length, resection margin and lymph node retrieval was equivalent between obese and nonobese patients. Disease-free survival and overall survival at a median follow up of 2 years were also similar.


CONCLUSIONS
Laparoscopic colorectal cancer surgery in obese patients is technically feasible and oncologically safe. Despite greater postoperative morbidity, obese patients benefit from shorter length of stay. However, a higher conversion rate, particularly for rectal cancers, should be anticipated in obese male patients.
Singh
A
A
The ICENI Centre, Colchester University Hospital NHS Foundation Trust, Turner Road, Colchester, Essex, UK.
Muthukumarasamy
G
G
Pawa
N
N
Riaz
A A
AA
Hendricks
J B
JB
Motson
R W
RW
D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003422:Critical Care; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome