Ryuichi Oshima1, Yukihito Kokuba1, Yuta Ogura1, Taichi Mafune1, Ryuichi Kishi1, Kuniyasu Horikoshi1, Keiichi Tanaka1, Takehito Otsubo2. 1Department of Gastroenterological Surgery, St. Marianna University Yokohama-City-West Hospital, 2Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
Introduction: There are reports of increased operative duration, blood loss and postoperative morbidity, caused by difficulties in obtaining good visualization and in controlling bleeding when laparoscopic resection is performed in obese patients with colon cancer.
Purpose: The aim of this study was to investigate the impact of obesity on perioperative outcomes after laparoscopic colorectal resection performed by various operative methods in our department.
Patients and Methods: We conducted a retrospective analysis of 435 patients with colorectal cancer who underwent laparoscopic surgery between January 2011 to December 2015. Right colectomy was performed in 84 patients, sigmoidectomy in 73 patients, and low anterior resection in 50 patients. The surgical outcomes were compared between non-obese (body mass index [BMI] <25 kg/m2) and obese (BMI ?25 kg/m2) patients.
Results: Right colectomy cases: The amount of blood loss was significantly increased in the obese group compared with the non-obese group, but operation time did not differ significantly between the groups. There were no significant differences between the two groups in the rate of postoperative complications and duration of post-operative hospitalization. Sigmoidectomy cases: There were no significant differences between the two groups in operation time and amount of blood loss. Even though the preoperative ASA score and the rate of postoperative complications were higher in the obese group, the mean postoperative hospital stay did not differ significantly between the two groups. Low anterior resection cases: There were no significant differences between the obese group and the non-obese groups in operation time, amount of blood loss, rate of postoperative complications, and duration of post-operative hospitalization.
Discussion: Although there are some reports of increased operative times in obese patients, the operative procedure was not extended in any of the present study patients. The amount of blood loss was significantly increased in the obese group compared with the non-obese group when right colectomy was performed. Among the patients undergoing sigmoidectomy, the postoperative rate of complications was higher in the obese group; however, the preoperative ASA status was also higher in the obese group than non-obese group, indicating that factors other than obesity may be involved.
Conclusion: We concluded that laparoscopic colorectal resection appeared to be safe and feasible in both obese patients and non-obese patients. However, BMI may not accurately reflect the amount of visceral fat present.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86662
Program Number: P220
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster