Is laparoscopic colorectal cancer surgery in obese patients associated with an increased risk? Short-term results from a single center study of 425 patients.
BACKGROUND
In laparoscopic colorectal cancer surgery, some authors still report increased conversion rates, operative duration and postoperative morbidity with longer hospital stay in obese patients. In our department, we had the impression that laparoscopic surgery in the obese was feasible and safe, leading to this study in which we evaluate laparoscopic surgery for colorectal cancers in the obese and measure the impact on short-term results.


METHODS
In the period from November 2004 to May 2010, 425 patients were laparoscopically operated for a colon or rectal cancer in our center. Ninety-three patients had a body mass index (BMI) ≥ 30. Demographic data and short-term outcome in patients with a BMI ≥ 30 were compared to the same data in patients with a BMI < 30.


RESULTS
The median operative time was significantly longer (240 vs. 225 min, p = 0.021) and the mean blood loss was significantly higher (348 vs. 285 ml, p = 0.034) in the group of patients with BMI ≥ 30. No other significant differences, including conversion to open surgery and postoperative morbidity, were found between the two groups.


CONCLUSIONS
Laparoscopic colorectal cancer surgery is feasible and safe in obese patients with a BMI above 30, without the patients experiencing an increased risk of postoperative morbidity or mortality.
Department of Surgery, Roskilde Hospital, Koegevej 7-13, 4000 Roskilde, Denmark. martinp@dadlnet.dk
Martin
M
Poulsen
Henrik
H
Ovesen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015992:Body Mass Index; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012306:Risk; D016896:Treatment Outcome