title: Body mass index and perioperative complications after oesophagectomy for adenocarcinoma: a systematic database review.
abstract: OBJECTIVE
  Given the increasing rate of obesity, the effects of excessive body weight on surgical outcomes constitute a relevant quality of care concern. Our aim was to determine the relationship between preoperative body mass index (BMI) on perioperative complications after oesophagectomy for adenocarcinoma of the oesophagus.
  
  
  METHODS
  Retrospective database review.
  
  
  METHODS
  Single institution high volume oncological tertiary care referral centre.
  
  
  METHODS
  From our comprehensive oesophageal cancer database consisting of 709 patients, we stratified patients according to BMI: 155 normal-weight (BMI 20-24), 198 overweight (BMI 25-29) and 187 obese (BMI ≥30) patients.
  
  
  METHODS
  All patients underwent oesophagectomy for cancer.
  
  
  METHODS
  Incidences of preoperative risk factors and perioperative complications in each group were analysed.
  
  
  RESULTS
  The patient cohort consisted of 474 men and 66 women with a mean age of 64.3 years (28-86). They were similar in terms of demographics and comorbidities, with the exception of a younger age (65.2 vs 65.4 vs 62.5 years, p=0.0094), and a higher incidence of diabetes (9.1% vs 13.2% vs 22.7%, p=0.001), hiatal hernia (16.8% vs 17.8% vs 28.8%, p=0.009) and Barrett oesophagus (24.7% vs 25.4% vs 36.2%, p=0.025) for obese patients. The type of surgery performed, overall blood loss, extent of lymphadenectomy, R0 resections and complications were not influenced by BMI on univariate and multivariate analysis.
  
  
  CONCLUSIONS
  In our experience, patients with an elevated BMI and oesophageal adenocarcinoma do not experience an increase in morbidity and mortality after oesophagectomy as stated in previous reports, when performed at a high volume centre. Additionally, BMI did not affect the quality of oncological resection as determined by number of harvested lymph-nodes and rates of R0 resections.
  
  
  BACKGROUND
  MCC 15030, IRB 105286.
authors: Department of Surgery, New York University Medical School, New York, New York, USA.
authors: Marcovalerio
authors: M
authors: Melis
authors: Jill
authors: J
authors: Weber
authors: Ravi
authors: R
authors: Shridhar
authors: Sarah
authors: S
authors: Hoffe
authors: Khaldoun
authors: K
authors: Almhanna
authors: Richard C
authors: RC
authors: Karl
authors: Kenneth L
authors: KL
authors: Meredith
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