Body mass index as a predictor of complications and conversion in patients undergoing laparoscopic colectomy

Abstract

OBJECTIVE: Evaluate the predictive value of body mass index (BMI) for hospital length-of-stay, surgical conversion, and postoperative complications in laparoscopic colorectal surgeries. METHODS: Retrospective analysis of 152 patients undergoing laparoscopic colorectal surgery. Patients were divided into two groups: group I (BMI<30) and group II (BMI>30). The average hospital length-of-stay and the complication and conversion rates of the groups were compared. RESULTS: Group II had a longer average hospital length-of-stay (9.852 versus 7.112 days) and higher conversion rate (33.3 versus 14.4%). BMI>30 is a risk factor for conversion, with odds ratio (OR) of 2.972 (95% confidence interval - CI 1.157-7.633). No significant difference was observed between the groups regarding complications. CONCLUSIONS: Obesity (BMI>30) significantly increases the conversion rate of laparoscopic colorectal surgery and increases the average hospital length-of-stay of patients.<br>OBJETIVO: Avaliar o valor preditor do índice de massa corporal (IMC) para o tempo de internação hospitalar, conversão cirúrgica e complicações pós-operatórias nas cirurgias laparoscópicas colorretais. MÉTODOS: Realizada análise retrospectiva de 152 pacientes submetidos à cirurgia laparoscópica colorretal. Os pacientes foram divididos em dois grupos: grupo I (IMC<30) e grupo II (IMC>30). Os grupos tiveram as médias de permanência hospitalar, as taxas de complicações e de conversão comparadas. RESULTADOS: O grupo II apresentou maior tempo médio de permanência hospitalar (9,852 versus 7,112 dias) e maior taxa de conversão (33,3 versus 14,4%), sendo o IMC>30 um fator de risco para conversão, com odds ratio (OR) de 2,972 (Intervalo de confiança - IC 95% 1,157-7,633). Não houve diferença significativa entre os grupos com relação às complicações. CONCLUSÕES: A obesidade (IMC>30), aumenta significativamente a taxa de conversão da cirurgia colorretal laparoscópica, assim como aumenta a média de tempo de permanência hospitalar dos pacientes

The new Body Mass Index as a predictor of postoperative complications in elective colorectal cancer surgery

“…No relation with other complications or mortality was found [17]. Costa and colleagues found that obesity (BMI !30) was associated with a higher conversion rate and longer hospital stay in laparoscopic colectomies [5]. In oncologic rectal surgery, obese patients do not have a significantly increased risk to develop postoperative complications compared with non-obese patients [3].…”

“…The conventional BMI was calculated as weight in kilograms divided by height in meters squared (kg/m 2 , conventional formula) and as 1.3 Â weight/height [2,5] (new formula) [7,9]. Both the conventional and new BMI were calculated for all patients.…”

“…Therefore, a new BMI formula has been developed recently. As height is given a larger impact in this new formula (1.3 Â weight/ height 2 , [5]), it has been considered to approximate reality better [9].…”