Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis

Zhou, Yanming; Wu, Lupeng; Li, Xiudong; Wu, Xiurong; Li, Bin

doi:10.1007/s00464-011-1952-2

Cited by 77 publications

(61 citation statements)

References 34 publications

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“…Obesity has been also described as a risk factor for surgical wound infection after conventional colorectal surgery [23,24]. Zou et al [25] reported that obesity was associated with increased wound infection, ileus, incisional hernia, and with pulmonary events. The incidence of wound infection seen in obese patients in our study, which was similar to that in other studies [26,27], was significantly higher than that in non-obese patients (8.3% vs 1.9%).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

et al. 2014

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Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

et al. 2014

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“…Zhou et al, en un reciente meta análisis 15 , encontraron un 34,8% de complicaciones en pacientes obesos comparado con un 23,4% en no obesos, especialmente complicaciones como íleo, infección de sitio quirúrgico y eventos pulmonares. Con respecto a filtración, abscesos, hemorragias y mortalidad no encontraron diferencias.…”

Section: Discussionunclassified

Factores asociados a morbilidad precoz en cirugía colorrectal laparoscópica

Gellona

et al. 2013

Rev Chil Cir

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Factors associated with early morbidity in laparoscopic colorectal surgery Introduction: Different factors have been associated with increased risk of complications in laparoscopic colorectal surgery. The aim of this study is to identify these factors in our series. Method: Retrospective cohort. All patients undergoing laparoscopic colorectal surgery between January 2000 and June 2012 were included. Patients who had postoperative complications until 30 days postoperatively were identified and analyzed by univariate and multivariate logistic regression. A p value less than 0.2 was used was used as a criteria for entry into the multivariate model. Results: The series consists of 848 patients with a median age of 58 ± 22 years. Main surgical indications were: neoplasia (42.3%), diverticular disease (27.8%) and inflammatory bowel disease (8.8%). Most frecuently-performed procedures were: sigmoidectomy (39.5%), anterior resection of the rectum (13.4%), right hemicolectomy (13%) and total colectomy (8.7%). On univariate analysis, factors associated with complications were age over 75 years (OR 1.82, 95% CI 1.02 to 3.25) and red blood cell transfusion (OR 8.47, 95% CI 3.69 to 19.43). On multivariate analysis, red blood cell transfusion (OR 7.9 95% CI 1.78 to 35.88) and ASA III or IV (OR 3.26 95% CI 1.01 to 17.23) were independent factors associated with postoperative complications. Conclusion: Intraoperative red blood cell transfusion and ASA score III or IV are independent risk factors associated with complications in laparoscopic colorectal surgery.

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“…A striking coefficient is the patient-specific individual anatomy and tumor manifestation: A narrow male pelvis, obesity, and bulky and low tumors can substantially hamper LS [8,9,16,28]. Hence, RS was proposed and has already demonstrated ability to address the problem of anatomical limitations in low anterior resection.…”

Section: Resultsmentioning

confidence: 99%

“…In lower gastrointestinal surgery, the broad implementation of minimally invasive procedures has been substantially hampered by the demanding anatomical and technical complexities of colorectal surgery such as the narrow male pelvis, obesity, locally advanced disease, low rectal masses, or the necessity of intracorporeal ileocolic anastomosis [8,9]. Moreover, certain pitfalls of the laparoscopic approach, such as 2-dimensional vision, tremor, and limitations in triangulation and motility, potentially impede the procedure.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, certain pitfalls of the laparoscopic approach, such as 2-dimensional vision, tremor, and limitations in triangulation and motility, potentially impede the procedure. Resulting in overall conversion rates of up to 30% [2,5,[10][11][12][13][14], which is associated with poor oncological outcome and higher morbidity [2,15], these drawbacks crucially impair surgical outcome [8,9,16]. Bridging this gap, several advancements now serve to facilitate minimally invasive surgery in challenging surgical situations.…”

Section: Introductionmentioning

confidence: 99%

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Lower Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures

et al. 2018

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Introduction: For a long time, the comprehensive application of minimally invasive techniques in lower gastrointestinal (GI) surgery was substantially impaired by inherent anatomical and technical complexities. Recently, several new techniques such as robotic operating platforms and transanal total mesorectal excision (taTME) have revolutionized the minimally invasive approach. This review aims to depict the current state of the art and evaluates the advantages and drawbacks in regard to perioperative outcome and quality of oncological resection. Methods: A systematic literature search was performed using the search terms ‘colorectal cancer', ‘rectal cancer', ‘minimally invasive surgery', ‘laparoscopic surgery', and ‘robotic' to identify relevant studies reporting on robotic surgery (RS) either alone or in comparison to laparoscopic surgery (LS). Publications on taTME were analyzed separately. Results: 69 studies reporting on RS with a total of 20,872 patients, and 17 articles on taTME including 881 patients, were identified. Conclusion: Both RS and taTME can facilitate a minimally invasive approach for lower GI surgery in an increasing number of patients. Furthermore, combining both techniques might become an auspicious approach in selected patients; further prospective and randomized trials are needed to verify its benefits over conventional laTME.

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Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis

Abstract: Obesity is associated with increased conversion rate, operating time, and postoperative morbidity of laparoscopic colorectal surgery but does not affect surgical safety or oncological security.

Cited by 77 publications

References 34 publications

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

Factores asociados a morbilidad precoz en cirugía colorrectal laparoscópica

Lower Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures

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