Yu Sato, MD, PhD, Atsuko Kataoka, MD, Rie Matsunaga, MD, Tomoko Horie, MD, Yoshimasa Gohda, MD, Yasutaka Shuno, MD, PhD, Hideaki Yano, MD, PhD. Department of Colorectal Surgery, National Center for Global Health and Medicine
Objective: The relationship between body mass index (BMI) and laparoscopic colon resection is unclear. The aim of this study was to determine whether obese patients undergoing laparoscopic resection for colon cancer had worse outcomes.
Methods: One hundred and seventy seven consecutive patients who underwent curative laparoscopic resection for stage 2 and 3 colon cancer between January 2009 and July 2016 in a single institution were identified from a prospective database. Patients were divided in two groups based on BMI. Obesity was defined by BMI > 25. Outcomes including operative data, the number of retrieved lymph nodes, anastomotic leakage, and recurrence were compared between the groups.
Results: One hundred and thirty three patients (75.1%) were of a healthy weight (BMI < 25), whilst 44 patients were classified as obese (24.9%). Both groups had comparable demographics, tumor location, tumor size, tumor stage and the degree of lymphadenectomy. Operative time, intraoperative estimated blood loss and the number of retrieved lymph nodes were no different between the two groups. The anastomotic leakage rate was significantly higher in obese patients (0.8% vs. 6.8%; p=0.048). With a median follow-up time of 19.5 months, there was no significant difference in the recurrence rate (14.3% in BMI < 25 vs. 20.5% in BMI > 25; p=0.346). The mean interval from the surgery to the recurrence was 13.1 (range, 3.2-32.6) months for the healthy weight patients and 9.9 (range, 1.6-36.1) months for the obese patients.
Conclusions: Obesity leads to increase anastomotic leakage in laparoscopic surgery for colon cancer. However, laparoscopic colon resection may be oncologically feasible in obese patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79071
Program Number: P256
Presentation Session: Poster (Non CME)
Presentation Type: Poster