Laparoscopic Colorectal Surgery in Obese Subjects Carries Higher Complication

Rejeesh Selvaganesan, MS, MCh, Puneet Dhar, MCh, Sudhindran S, MS, FRCS, Unnikrishnan G, MS, DNB, Dinesh Balakrishnan, MS, DNB, Ramachandran Menon, MS, DNB, Sudeer O.v, MS, MCh

AMRITA INSTITUTE OF MEDICAL SCIENCES AND RESEARCH CENTER, KERALA, INDIA

Introduction

Obesity has generally been considered as a risk factor for both conventional and laparoscopic surgery.
The aim of this study is to assess the post-operative outcome of Laparoscopic colectomy for colorectal cancers in obese patients compared to non-obese patients.

Materials and methods

Patients undergoing laparoscopic colorectal procedures for colorectal cancers during 2009-2011 were retrospectively analyzed. The patients were categorized into two groups BMI <25 and BMI > 25.
The post-operative outcomes with respect to Wound infection, conversion rate to open procedure, cardio-pulmonary complications, renal complications, hospital stay, rate of Re-exploration and death were analyzed.
Statistical analysis consisted of chi-square analysis.

Results:

A total number of 148 patients underwent laparoscopic colorectal surgery during the period 2009-2011. 94 (63.5%) patients had BMI under 25 and 54 (36.5%) patients had BMI above 25.
The analysis of the collected data shows that, the incidence of wound infection was 35% and 16% in obese and non-obese group respectively (P value 0.07).
Conversion to open was significantly higher in obese group (18.5%) vs. in non-obese group (6.4 %) (P value 0.029).
However other complications like cardiopulmonary, renal complications or mortality did not show statistical significance in obese and non-obese group.
Re-exploration rate were 5.6% in obese group and 2.1% in non-obese group (not satisfactorily significant P value 0.355).
37% of obese patients got discharged after 10 days compared to 13.8 % of non-obese patients (P value 0.02).

Conclusion

These retrospective data shows that colorectal surgery in obese patient carries higher risk in terms of post-operative wound infection.
The rate of conversion to open surgery and duration of hospital stay was more in obese patients than non-obese patients, but other complications and mortality risk was not significant.
It is recommended that a proper randomized study with larger number of patients to be used to evaluate this prospectively.

Session: Poster Presentation

Program Number: P058