title: The influence of obesity on short- and long-term outcomes after laparoscopic surgery for colon cancer: a case-matched study of 152 patients.
abstract: BACKGROUND
  Despite the increasing prevalence of obesity and colonic diseases, the impact of obesity on short-term and oncologic outcomes of laparoscopic colorectal surgery still remains unclear.
  
  
  METHODS
  Seventy-six consecutive obese patients with body mass index (BMI) ≥30 kg/m(2) who underwent laparoscopic colectomy were matched with 76 nonobese patients with BMI <30 kg/m(2). Perioperative parameters and oncologic outcomes were analyzed in the two groups.
  
  
  RESULTS
  Obesity was associated with greater operative time (obese vs nonobese, 182 ± 59 vs 157 ± 55 min, P = .0084) and multivariate analysis identified BMI (hazard ratio 2.11, 95% confidence interval 0.64-3.56, P = .0049) as an independent predicting factor for operative time together with cancer location (hazard ratio 28.6, 95% confidence interval 14.62-42.51, P < .0001). Obesity had no adverse influence on overall morbidity (25 vs 21%, P = .563), however, or postoperative duration of stay (median 6.0 vs 5.5 days, P = .22). Furthermore, the rate of conversion to open procedure was similar between the two groups (9 vs 9%, P > .99). Regarding oncologic outcomes, there was no statistical difference in overall and disease-free survival between the two groups (5-year overall survival rate 86 vs 89%, P = .72, 5-year disease survival rate 70 vs 77%, P = .70).
  
  
  CONCLUSIONS
  Laparoscopic colonic resection, when performed for selected patients, appears to be a safe and reasonable option in obese patients with colon cancer resulting in similar short-term and oncologic outcomes as nonobese patients.
authors.affiliation: Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Makino
authors.affiliation: Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY.
authors.forename: Koiana
authors.initials: K
authors.lastname: Trencheva
authors.affiliation: Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY.
authors.forename: Parul J
authors.initials: PJ
authors.lastname: Shukla
authors.affiliation: Division of Metabolic Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rubino
authors.affiliation: Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY; Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Changhua
authors.initials: C
authors.lastname: Zhuo
authors.affiliation: Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY.
authors.forename: Raghava S
authors.initials: RS
authors.lastname: Pavoor
authors.affiliation: Section of Colon & Rectal Surgery, New York Presbyterian Hospital & Weill Cornell Medical College, New York, NY. Electronic address: mim2035@med.cornell.edu.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Milsom
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003082:Colectomy; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000473:pathology; D061646:Operative Time; D013997:Time Factors; D016896:Treatment Outcome