Advantage of laparoscopic surgery in patients with generalized obesity operated for colorectal malignancy: A retrospective cohort study

Abstract

BackgroundBecause of the progression of minimally invasive surgery skills and obesity in colorectal surgery, we aimed to evaluate the short-term outcomes of colorectal cancer resections in patients with generalized obesity at a single teaching hospital with mature surgical techniques and training programs.MethodsA total of 537 patients were diagnosed with CRC and had a body mass index ≥30 kg/m2 between January 2009 and December 2019 at a single institution. 265 patients underwent open surgery and 272 patients underwent laparoscopic surgery. Data were analysed to explore the independent risk factors for postoperative complications.ResultsThe laparoscopic group had less blood loss (73 ± 128 vs. 148 ± 290 ml, p < 0.001) and a shorter postoperative hospital stay (10.8 ± 17.1 vs. 11.7 ± 6.8 days, p < 0.001) than the open group. The number of harvested lymph nodes did not significantly differ between the two groups (30.9 ± 18.3 vs. 30.2 ± 15.3, p = 0.981). Although anastomotic leakage was significantly higher in the laparoscopic group (1.5% vs. 4.8%, p = 0.030), there were also similar overall postoperative morbidity and mortality rates between the open and laparoscopic groups for CRC patients with generalized obesity who underwent surgery.ConclusionLaparoscopic surgery can reduce blood loss, decrease the length of hospital stay, obtain a similar number of harvested lymph nodes, and achieve an acceptable conversion rate for CRC patients with generalized obesity. We suggest that laparoscopic surgery could become a standard method for CRC treatment in patients with generalized obesity.

Prospective randomized comparison of three‐dimensional (3D) versus conventional laparoscopy in total colectomy for ulcerative colitis

“…Exclusion of morbidly obese patients may also be considered as a limitation as these patients obtain high benefit from laparoscopic surgery. However, obese patients pose many challenges to surgery, leading to longer operative times when compared with non‐obese patients 12 . Since the primary outcome in this study was the operative time, inclusion of morbidly obese patients might have introduced biases.…”

“…However, obese patients pose many challenges to surgery, leading to longer operative times when compared with non-obese patients. 12 Since the primary outcome in this study was the operative time, inclusion of morbidly obese patients might have introduced biases. Therefore, they are excluded from the study.…”