Laparoscopic Colorectal Surgery in Obese Patients

Abstract

With sufficient experience, laparoscopic colorectal surgery in obese patients is feasible and safe. It is associated with no increased risk of complications and preserves all benefits of the mini-invasive approach.

The impact of obesity on outcomes of laparoscopic surgery for colorectal cancer in Asians

“…Studies in Western populations have shown that obese patients undergoing laparoscopic colorectal surgery are at increased risk of conversion to an open procedure [1][2][3]17]. It is unclear, however, whether complication rates are higher and operative times are longer in obese patients who undergo laparoscopic resection [1][2][3][4][5][6][7][8].…”

“…Conclusions With sufficient experience, laparoscopic colorectal surgery in obese Asian patients is feasible and safe, offering all the benefits of a minimally invasive approach. Management of Asian colorectal cancer patients with BMI C 30 kg/m 2 requires meticulous perioperative care, and colorectal surgeons must be familiar with obesityrelated challenges in such patients.Keywords Colorectal cancer Á Laparoscopic surgery Á Body mass index Á Asian Á Obesity Although obesity is associated with various health risks and is considered a risk factor for postoperative morbidity after abdominal surgery, the effect of obesity on the outcomes of laparoscopic colorectal surgery is unclear [1][2][3][4][5][6][7][8]. In the past, obesity was considered to be a relative contraindication to laparoscopy, as the condition was associated with technical difficulties during the procedure [9].…”

“…In some studies, obese patients showed longer operation time and higher morbidity, mortality, and open conversion rates than did nonobese patients [1,2]. However, other studies reported that obesity did not have an adverse impact on either technical procedures or postoperative outcomes of laparoscopic colectomy [3][4][5][6][7][8].…”

Is the laparoscopic approach to colectomy safe for the morbidly obese?

“…These studies also have used variable definitions of morbid obesity. Most studies [10][11][12][13] have compared outcomes for obese (BMI [ 30 kg/m 3 ), and nonobese (BMI \ 30 kg/m 3 ) patients undergoing LC, with comparable reported outcomes. Conversely, other studies [3,14] have reported significantly greater postoperative morbidity BMI body mass index a A P value less than 0.05 is considered statistically significant b Wilcoxon rank sum test for obese than for nonobese patients.…”

Clinical Study of Causative Factors, Precautionary Measures and the Treatment of Surgical Site Infections (SSIs) in Elective General Surgery Cases at Dr B.R.AMCH

“…The literature shows that SSI increases with obesity, one reason being a decrease in blood circulation in fat tissues. [8][9] Recent preliminary findings from a study of patients who underwent coronary artery bypass graft showed a significant relationship between increasing levels of HbA1c and SSI rates. Also, increased glucose levels (>200 mg/dL) in the immediate postoperative period (<48 hours) were associated with increased SSI risk.…”