Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis.
BACKGROUND
Obese patients are generally believed to be at increased risk for surgery compared with those who are not obese. A meta-analysis was performed to assess the outcomes of laparoscopic colorectal surgery in obese and nonobese patients.


METHODS
A systematic literature search from inception to June 2011 was performed. Pooled odds ratios (OR) and weighted mean differences (WMD) with 95% confidence intervals (95% CI) were calculated using the fixed effects model or random effects model.


RESULTS
Eight observational studies identified and matched the selection criteria. Conversion rates (OR: 2.31, 95% CI: 1.74-3.08), operating time (WMD: 15.33, 95% CI: 1.81-28.85), and postoperative morbidity (OR: 2.11; 95% CI: 1.3-3.42) were all significantly increased in the obese group. Length of hospital stay and mortality were similar in both groups. For patients with cancer, there was no difference between groups for the number of harvested nodes and length of specimen.


CONCLUSIONS
Obesity is associated with increased conversion rate, operating time, and postoperative morbidity of laparoscopic colorectal surgery but does not affect surgical safety or oncological security.
Department of Hepato-Biliary-Pancreato-Vascular Surgery, the First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, Fujian Province, China.
Yanming
Y
Zhou
Lupeng
L
Wu
Xiudong
X
Li
Xiurong
X
Wu
Bin
B
Li
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012002:Rectal Diseases / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome