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

Kinugasa, Tetsushi; Yoshida, Takefumi; Mizobe, Tomoaki; Isobe, Taro; Oka, Yoshitomo; Akagi, Yoshito

doi:10.2739/kurumemedj.ms64005

Cited by 4 publications

(11 citation statements)

References 29 publications

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“…As collated in our results, R1 resection was higher in the NOB group, with estimated pooled rate of 6.9% compared to 3.1% in the OB group. This reached statistical significance with a larger number of patients, as individual studies did not show any difference . Subanalysis of only rectal cancers did not show any difference, with similar R1 and CRM positivity between the two cohorts.…”

Section: Discussionmentioning

confidence: 71%

Oncological safety of laparoscopic versus open colorectal cancer surgery in obesity: a systematic review and meta‐analysis

Bell

Kong

Carne

et al. 2019

ANZ Journal of Surgery

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Background Colorectal cancer resection in the obese (OB) patients can be technically challenging. With the increasing adoption of laparoscopic surgery, the benefits remain uncertain. Hence, the aim of this study is to assess the short‐ and long‐term outcomes of laparoscopic compared to open colorectal cancer resection in the OB patients. Methods A systematic review and meta‐analysis was performed according to the PRISMA guidelines. The outcome measures were 5‐year disease‐free survival, overall survival, circumferential resection margin and local and distant recurrence. Results A total of 20 studies were included, with a total number of 6779 participants, of whom 1785 (26.3%) were OB and 4994 (73.7%) were non‐obese (NOB) participants. The OB patients had higher R1 resection (OB 6.9% versus NOB 3.1%; P = 0.011) and lower mean number of lymph nodes harvested, with standard mean difference of −0.29; P = 0.023, favouring the NOB patients. However, there was no statistical difference for local (OB 2.8% versus NOB 3.4%) or distant recurrence (OB 12.9% versus NOB 15.2%) rate between the two cohorts. There was no difference in 5‐year disease‐free survival (OB 81% versus NOB 77.4%; odds ratio 1.25, P = 0.215) and overall survival (OB 89.4% versus NOB 87.9%; odds ratio 1.16, P = 0.572). Lastly, the OB group had higher mean total blood loss, total operative time and length of hospital stay when compared to NOB patients. Conclusion From a pooled non‐randomized study, laparoscopic colorectal cancer resection is safe in OB patients with equivalent long‐term outcomes compared to NOB patients. However, there is a higher morbidity rate with an increased demand on hospital resources for the OB cohort.

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Section: Discussionmentioning

confidence: 71%

Oncological safety of laparoscopic versus open colorectal cancer surgery in obesity: a systematic review and meta‐analysis

Bell

Kong

Carne

et al. 2019

ANZ Journal of Surgery

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“…Overall operative time was included in the majority of studies and was the only reported outcome that was associated with obesity in a majority of publications (Table ) . Among the 70 studies that included operative time as an outcome metric, 42 (60%) reported that obesity was associated with a longer operative time …”

Section: Resultsmentioning

confidence: 99%

“…A subset analysis was performed that examined SSI data among patients with colorectal cancer relative to surgical approach. Among the 54 studies on colorectal cancer, 16 included data on minimally invasive techniques . Among these 16 studies, 3 did not evaluate SSI .…”

Section: Resultsmentioning

confidence: 99%

“…Among the 54 studies on colorectal cancer, 16 included data on minimally invasive techniques . Among these 16 studies, 3 did not evaluate SSI . Among the other 13 studies of patients with colorectal cancer who underwent a laparoscopic resection, 10 (76.9%) reported no difference in the incidence of SSI among obese and non‐obese patients .…”

Section: Resultsmentioning

confidence: 99%

“…Among the 75 studies that examined SSI, roughly half of the studies (57.3%) did not detect a difference among obese and nonobese patients. 10 32,37,46,48,49,55,[58][59][60][61][62][64][65][66][67]70 Among these 16 studies, 3 did not evaluate SSI. 49,61,64 Among the other 13 studies of patients with colorectal cancer who underwent a laparoscopic resection, 10 (76.9%) reported no difference in the incidence of SSI among obese and non-obese patients.…”

Section: Study Characteristics and Operative Detailsmentioning

confidence: 99%

See 2 more Smart Citations

Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review

Hughes

Shah

Noria

et al. 2018

Journal of Surgical Oncology

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We systematically reviewed 118 studies comparing peri-operative outcomes among obese and non-obese patients. Obesity was associated with longer operative time in 60% of available studies. Just 35.8% of studies that evaluated overall morbidity identified high morbidity in obese patients. Lymph node yield or surgical margin status, was only affected by obesity in 19.6% of studies. In this review obesity was frequently found to have no effect on peri-operative and oncologic outcomes.

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The risk factors for incisional hernia after laparoscopic colorectal surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group

et al. 2020

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

Cited by 4 publications

References 29 publications

Oncological safety of laparoscopic versus open colorectal cancer surgery in obesity: a systematic review and meta‐analysis

Oncological safety of laparoscopic versus open colorectal cancer surgery in obesity: a systematic review and meta‐analysis

Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review

The risk factors for incisional hernia after laparoscopic colorectal surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group

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