Does obesity increase early postoperative complications after laparoscopic colorectal surgery? Results from a single center
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Laparoscopic colorectal surgery (LCRS) has several advantages over open surgery, but LCRS has been associated with a higher rate of postoperative complications (POCs) among obese patients [body mass index (BMI), ≥30 kg/m2]. The prevalence of obesity in Chile is increasing, up to 25.1 % in 2010, suggesting that a higher percentage of patients undergoing LCRS will be obese. This study compared POC rates between obese and nonobese patients undergoing LCRS.
This study included case and control patients in a prospectively maintained LCRS database who underwent LCRS between July 2007 and June 2012 at Clinica Las Condes, Santiago, Chile. Obese and nonobese (BMI <30 kg/m2) patients were paired by gender, age, American Society of Anesthesiologists class, preoperative diagnosis, and type of surgery. Intraoperative complications and POCs were documented up to 30 days. The severity of each POC was classified by Clavien–Dindo score.
In this study, 449 patients who underwent LCRS during the study period were identified. The study paired 53 obese patients (mean BMI 33.1 kg/m2) with 53 nonobese patients (mean BMI 25.9 kg/m2). The median age was 55 years in the obese group and 57 years in the nonobese group, and 60 % of the patients in both groups were men. The findings showed POCs in 13 obese (24.5 %) and 15 nonobese (28.3 %) patients (p = 0.66). Stratified by severity of POCs, the two groups were similar (p = 0.62). The two groups did not differ in terms of the median time to the first feeding (1 day each) or the hospital length of stay (4 days each). Similar percentages of patients in the two groups required reoperation (p = 0.4), intensive care unit (ICU) admission (p = 0.77), and readmission to the hospital (p = 0.65) because of POCs.
The frequency of POCs after LCRS was no higher among the obese patients than among the nonobese patients.
KeywordsPostoperative complications Obesity Colorectal surgery Laparoscopic surgery Early complications Obese patients
We thank Dr. Rodrigo Quera for revision of the final manuscript, Daniela Simian (RN) for her help in gathering information, and Dr. Federico Aronsohn for revision of the traduced final manuscript.
Camila Estay, Alejandro J. Zarate, Magdalena Castro, Udo Kronberg, Francisco López-Kostner, and Claudio Wainstein have no conflicts of interest or financial ties to disclose.
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