title: Is laparoscopic colorectal cancer surgery associated with an increased risk in obese patients? A retrospective study from China.
abstract: BACKGROUND
  The impact of obesity on surgical outcomes after laparoscopic colorectal cancer resection in Chinese patients is still unclear.
  
  
  METHODS
  We retrospectively reviewed the prospectively collected data from 527 consecutive colorectal cancer patients who under went laparoscopic resection from January 2008 to September 2013. Patients were categorized into three groups: nonobese (body mass index (BMI) <25.0 kg/m2), obese I (BMI 25.0 = to 29.9 kg/m2) and obese II (BMI ≥30.0 kg/m2). Clinical characteristics, surgical outcomes and postoperative complications were compared between nonobese, obese I and obese II patients.
  
  
  RESULTS
  From among the 527 patients, there were 371 patients with in the nonobese group, 142 patients in the obese I group and 14 patients in the obese II group. The patients were well-matched for age, sex and American Society of Anesthesiologists class, except for BMI (P = 0.001). The median operative time correlated highly significantly with increasing weight (median: nonobese = 135 minutes, obese I = 145 minutes, obese II = 162.5 minutes; P = 0.001). There appeared to be a slight tendency toward grade III complications (rated according to the Clavien-Dindo Classification of Surgical Complications) in the obese II group, but this difference was not significant (nonobese = 5.1%, obese I = 3.5% and obese II = 14.3%; P = 0.178). None of the grade III complications which occurred in the obese II group were wound dehiscences that required a stitch. Other aspects, such as estimated blood loss, harvested lymph nodes, operation type, pathological results, conversion rate and overall postoperative complications, were not statistically significant.
  
  
  CONCLUSIONS
  With sufficient experience, laparoscopic colorectal cancer surgery is feasible and safe in obese Chinese patients.
authors.forename: Xiang
authors.initials: X
authors.lastname: Xia
authors.forename: Chen
authors.initials: C
authors.lastname: Huang
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
authors.forename: Gang
authors.initials: G
authors.lastname: Cen
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, 100 Hai Ning Road Shanghai 200080 People's Republic of China. huangkjdoctor@sina.com.
authors.forename: Kejian
authors.initials: K
authors.lastname: Huang
authors.forename: Zhengjun
authors.initials: Z
authors.lastname: Qiu
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies