Obese Patients Undergoing Ileal Pouch–Anal Anastomosis

Abstract

Obesity impacts intraoperative complexity and 30-day postoperative outcomes. Long-term functional outcomes are not affected. These findings underscore the need to counsel patients on preoperative weight loss before undergoing elective IPAA.

Obesity in inflammatory bowel disease: A review of its role in the pathogenesis, natural history, and treatment of IBD

“…[ 39 ] Obesity also appears to increase intraoperative times, overall complexity of intra-abdominal operations, and the likelihood of conversion from laparoscopic to open procedures. [ 40 ] Technical challenges that obesity may generate with respect to commonly performed IBD-related operations of stoma formation and ileal pouch-anal anastomosis (IPAA) are worth special mention.…”

“…While there are reports suggesting that these issues may increase the risk of postoperative complications such as pelvic sepsis, which can be an important predictor of long-term pouch function,[ 42 ] others have suggested that for obese patients who undergo three-stage IPAA with use of a diverting stoma in high-volume centers, long-term outcomes may be similar. [ 40 ] The potential added advantage of pursuing IPAA in three stages is that this may provide a window of opportunity following abdominal colectomy and ileostomy formation for the patient to pursue intensive weight-loss strategies prior to restoration of bowel continuity.…”

Short- and Long-term Outcomes of Ileal Pouch Anal Anastomosis Construction in Obese Patients With Ulcerative Colitis

“…In comparison with other literature, our data largely support what other studies have demonstrated regarding case duration and length of stay. The second largest study of obese patients with UC undergoing pouch surgery by McKenna et al, 17 as well as a smaller series from Cleveland Clinic Florida by Efron et al, 16 also identified longer operating times and lengths of stay in obese patients. Our study differs from these other publications in the use of statistical matching before multivariable regression analysis and a greater sample size with longer follow-up.…”

Colectomy for patients with super obesity: current practice and surgical morbidity in the United States

“…The increasing incidence of obesity among patients with colorectal diseases is a reflection of the obesity epidemic in the United States [14][15][16]. Obesity itself is a predisposing factor for colon cancer [17][18][19] and represents a wellknown risk factor for postoperative adverse events [20][21][22]. Super obesity was repeatedly identified as the strongest predictor of perioperative morbidity for different intraabdominal operations [23,24].…”