Impact of BMI on Postoperative Outcomes in Patients Undergoing Proctectomy for Rectal Cancer

Abstract

Obese and underweight patients undergoing proctectomy for neoplasm are at a higher risk for postoperative complications and death.

Impact of Body Mass Index on Early Postoperative and Long-Term Outcome after Rectal Cancer Surgery

“…In our study, the physical status (ASA) was worse in those patients, which also showed more comorbidities, especially cardiovascular risk factors and diabetes mellitus (data not shown). These findings are not surprising and have been widely described in the literature [2,[13][14][15].…”

“…In our analysis, 2.1% of all patients were underweight, compared to national population data of 0.1-0.2% in men and 0.2-1.9% in women depending on the age group of 60-69 or 70-79 years, respectively [12]. Preoperative weight loss is more common in underweight patients than in others [13,17]. Prospective randomized controlled trials, in which parameters of malnutrition are also analyzed, are necessary for further investigation of this topic.…”

“…Increased morbidity in obese patients was mostly due to higher rates of wound infections. The association of obesity and infectious complications has been consistently shown in the literature [2,3,[13][14][15]17]. Options to reduce this increase in morbidity after general surgery and particularly rectal cancer resections include a laparoscopic approach or high inspired oxygen concentrations perioperatively [18,19].…”

Caracterização do perfil epidemiológico do paciente com câncer de reto no Instituto do Câncer do Estado de São Paulo: determinação dos fatores associados ao tempo de internação hospitalar do paciente cirúrgico

“…A obesidade é atribuída como fator de pior prognóstico para pacientes com neoplasias gastrintestinais, inclusive câncer retal, para os desfechos de curto prazo, tais como maior propensão ao aparecimento de fístulas e complicações relacionadas à ferida operatória (22,23,57,58,59,60 pacientes com baixo peso apresentam maior risco de mortalidade no pós-operatório quando comparados a pacientes com sobrepeso ou obesidade moderada (23,64).…”

“…Este padrão mostra que os piores desfechos no pós-operatório associam-se com os extremos do IMC, ou seja, pacientes com baixo peso ou pacientes com obesidade severa, e é comumente chamado de padrão em "forma de U" (21,22).…”