Does obesity increase early postoperative complications after laparoscopic colorectal surgery? Results from a single center.
BACKGROUND
Laparoscopic colorectal surgery (LCRS) has several advantages over open surgery, but LCRS has been associated with a higher rate of postoperative complications (POCs) among obese patients [body mass index (BMI), ≥30 kg/m(2)]. The prevalence of obesity in Chile is increasing, up to 25.1% in 2010, suggesting that a higher percentage of patients undergoing LCRS will be obese. This study compared POC rates between obese and nonobese patients undergoing LCRS.


METHODS
This study included case and control patients in a prospectively maintained LCRS database who underwent LCRS between July 2007 and June 2012 at Clinica Las Condes, Santiago, Chile. Obese and nonobese (BMI <30 kg/m(2)) patients were paired by gender, age, American Society of Anesthesiologists class, preoperative diagnosis, and type of surgery. Intraoperative complications and POCs were documented up to 30 days. The severity of each POC was classified by Clavien-Dindo score.


RESULTS
In this study, 449 patients who underwent LCRS during the study period were identified. The study paired 53 obese patients (mean BMI 33.1 kg/m(2)) with 53 nonobese patients (mean BMI 25.9 kg/m(2)). The median age was 55 years in the obese group and 57 years in the nonobese group, and 60% of the patients in both groups were men. The findings showed POCs in 13 obese (24.5%) and 15 nonobese (28.3%) patients (p = 0.66). Stratified by severity of POCs, the two groups were similar (p = 0.62). The two groups did not differ in terms of the median time to the first feeding (1 day each) or the hospital length of stay (4 days each). Similar percentages of patients in the two groups required reoperation (p = 0.4), intensive care unit (ICU) admission (p = 0.77), and readmission to the hospital (p = 0.65) because of POCs.


CONCLUSIONS
The frequency of POCs after LCRS was no higher among the obese patients than among the nonobese patients.
Colorectal Unit, Surgery Department, Clinica Las Condes, Lo Fontecilla 441, 7550000, Santiago, Chile, camiestayh@gmail.com.
Camila
C
Estay
Alejandro J
AJ
Zarate
Magdalena
M
Castro
Udo
U
Kronberg
Francisco
F
López-Köstner
Claudio
C
Wainstein
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D002677:Chile; D015331:Cohort Studies; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000601:surgery*