Impact of Obesity on Operation Performed, Complications, and Long-term Outcomes in Terms of Restoration of Intestinal Continuity for Patients With Mid and Low Rectal Cancer

Abstract

At a high-volume specialized colorectal unit, proctectomy can be performed in obese patients with similar long-term oncologic outcomes and ability to restore intestinal continuity in comparison with nonobese patients. Proctectomy in obese patients, however, is associated with an increased risk of anastomotic leak in comparison with nonobese patients.

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

“…In particular, studies with large sample sizes show concordant results [3,5,15] despite the fact that there is literature reporting no(t) significantly increased morbidity rates [14,16]. Increased morbidity in obese patients was mostly due to higher rates of wound infections.…”

“…Furthermore, underweight patients showed advanced and overweight as well as obese patients had significantly less advanced tumor stages according to UICC than normal-weight individuals (p < 0.001). UICC-IV carcinoma patients were found in 26.1% of all underweight patients compared to 21.0% in normal-weight, 16 The postoperative morbidity was 38.0%. If the patient was underweight (43.4%) or obese (42.9%), this rate was significantly higher than in normal-weight (36.6%) or overweight (36.8%) patients (p < 0.001).…”

Association of obesity and overweight with overall survival in colorectal cancer patients: a meta-analysis of 29 studies

“…The main characteristics of the 29 included studies are summarized in Table 1. Of the included studies, 14 were conducted in North America [11,12,21,22,24,25,28,32,34,37,38,41,42,44], five were conducted in Europe [14,26,27,30,40], six were conducted in Asia [15,23,31,33,35,36], three were conducted in Oceania [13,29,43], and one study included multiple cohorts from North America and Europe [39].…”

Colorecral Anastomosis Failure (Literature Review)

“…Влияние нутритивного статуса (протеинемия ниже 60 г/л) пациента на развитие НШКРА подтверждено в ряде исследований [49]. По данным E. Aytac et al [23], M.J. Kim et al [33], ожирение (ИМТ более 25-30 кг/м 2 ) является значимым фактором риска развития НШКРА. Вопрос о влиянии предопера-ционного специализированного лечения остается спорным [3].…”