Laparoscopic colorectal cancer resections in the obese: a systematic review

Fung, Alastair; Trabulsi, Nora; Morris, Martin; Garfinkle, Richard; Saleem, Abdulaziz; Wexner, Steven D.; Vasilevsky, Carol‐Ann; Boutros, Marylise

doi:10.1007/s00464-016-5209-y

Cited by 60 publications

(52 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, on the basis of these studies, it was difficult to determine whether or not LAC for obese patients was acceptable. To date, there have been no randomized-controlled trials comparing LAC and OC for colorectal cancer in obese patients, and only limited numbers of retrospective studies have been performed (6,9,11,(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

“…In terms of short-term outcomes, randomized controlled trials have generally shown advantages of the minimal invasiveness of LAC in terms of reduced blood loss, earlier recovery, and lower complication rates compared with those of open colectomy (OC). When the focus is obese patients, however, increased postoperative complications (6), reoperation rates (7) and conversion rates (8)(9)(10)(11) have been reported for LAC. A possible explanation for this inverse effect may be the technical difficulty in maintaining adequate surgical views in the presence of bulky visceral fat.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²

Kazama

Numata

Aoyama

et al. 2020

In Vivo

View full text Add to dashboard Cite

Aim: To compare long-and short-term outcomes of laparoscopic surgery with those of open surgery for patients with colorectal cancer and body mass index over 25 kg/m 2. Patients and Methods: This multicentre, retrospective study analysed clinical records and identified 178 patients with body mass index over 25 kg/m 2 who underwent surgery for colon and rectosigmoid cancer between 2000 and 2016. After applying propensity score matching, 96 patients were finally included. The primary outcome was the 3-year recurrence-free survival rate, and the secondary outcomes were short-term results during and after surgery. Results: The 3-year recurrence-free survival rates were similar for the laparoscopic and open surgery groups. The laparoscopic surgery group had longer operative times but less blood loss and shorter periods of hospital stay. There were no differences in incidence of postoperative complications. Conclusion: Laparoscopic and open surgeries had similar longterm outcomes for obese patients. Laparoscopic surgery is an effective option for this population.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²

Kazama

Numata

Aoyama

et al. 2020

In Vivo

View full text Add to dashboard Cite

show abstract

“…A meta‐analysis (n = 4550) of laparoscopic surgery by Fung et al found that, for colorectal cancer surgery, SSI, leakage, morbidity, and conversion rate are significantly higher in patients with BMI > 30 than in those with normal BMI. Table shows a summary of past studies on the effects of obesity on outcomes of colorectal surgery.…”

Section: Colorectal Surgerymentioning

confidence: 99%

Obesity as a surgical risk factor

Aikou

Seto

2017

Annals of Gastroent Surgery

140

View full text Add to dashboard Cite

In recent years, both the actual number of overweight/obese individuals and their proportion of the population have steadily been rising worldwide and obesity‐related diseases have become major health concerns. In addition, as obesity is associated with an increased incidence of gastroenterological cancer, the number of obese patients has also been increasing in the field of gastroenterological surgery. While the influence of obesity on gastroenterological surgery has been widely studied, very few reports have focused on individual organs or surgical procedures, using a cross‐sectional study design. In the present review, we aimed to summarize the impacts of obesity on surgeries for the esophagus, stomach, colorectum, liver and pancreas. In general, obesity prolongs operative time. As to short‐term postoperative outcomes, obesity might be a risk for certain complications, depending on the procedure carried out. In contrast, it is possible that obesity doesn't adversely impact long‐term surgical outcomes. The influences of obesity on surgery are made even more complex by various categories of operative outcomes, surgical procedures, and differences in obesity among races. Therefore, it is important to appropriately evaluate perioperative risk factors, including obesity.

show abstract

“…Because obesity is increasing globally, managing obese patients is clinically demanding. A recent systematic review showed that laparoscopic surgery for rectal cancer in obese patients is technically challenging because of the longer operative times, higher risk of postoperative complications, and higher rates of conversion to OS compared with non‐obese patients . Recent retrospective case‐control studies that compared obese versus non‐obese patients (body mass index of ≥30 vs <30 kg/m 2 , respectively) undergoing robotic colorectal surgery consistently showed no difference in the conversion rate, rate of CRM, intraoperative or postoperative complications, or length of hospital stay .…”

Section: Short‐term Outcomesmentioning

confidence: 99%

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Matsuyama

Kinugasa

Nakajima

et al. 2018

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Interest in minimally invasive surgery has increased in recent decades. Robotic‐assisted laparoscopic surgery (RALS) was introduced as the latest advance in minimally invasive surgery. RALS has the potential to provide better clinical outcomes in rectal cancer surgery, allowing for precise dissection in the narrow pelvic space. In addition, RALS represents an important advancement in surgical education with respect to use of the dual‐console robotic surgery system. Because the public health insurance systems in Japan have covered the cost of RALS for rectal cancer since April 2018, RALS has been attracting increasingly more attention. Although no overall robust evidence has yet shown that RALS is superior to laparoscopic or open surgery, the current evidence supports the notion that technically demanding subgroups (patients with obesity, male patients, and patients treated by extended procedures) may benefit from RALS. Technological innovation is a constantly evolving field. Several companies have been developing new robotic systems that incorporate new technology. This competition among companies in the development of such systems is anticipated to lead to further improvements in patient outcomes as well as drive down the cost of RALS, which is one main concern of this new technique.

show abstract

Laparoscopic colorectal cancer resections in the obese: a systematic review

Cited by 60 publications

References 53 publications

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²

Obesity as a surgical risk factor

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Contact Info

Product

Resources

About

Laparoscopic colorectal cancer resections in the obese: a systematic review

Cited by 60 publications

References 53 publications

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m2

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m2

Obesity as a surgical risk factor

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Contact Info

Product

Resources

About

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²

Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²