Abstract
Purpose
This study compared the results of laparoscopic surgery for colon cancer in obese patients with a body-mass index (BMI) of 25 kg/m2 or higher with those in nonobese patients (BMI <25 kg/m2) who were matched for clinicohistopathological factors.
Methods
The oncologic outcomes were compared between 140 patients with a BMI of 25 kg/m2 or higher (obese group) and 140 patients with a BMI of <25 kg/m2 (nonobese group) that were matched for sex, tumor location, date of operation, and pTNM stage.
Results
The proportion of patients with postoperative complications was significantly higher in the obese group (15 %) than in the nonobese group (6 %). The disease-free survival rate and overall survival rate in patients with stage I or II disease were similar in the obese group (98.6 and 98.8 %, respectively) and the nonobese group (97.8 and 97.8 %, respectively). The disease-free survival rate and overall survival rate in patients with stage III disease also did not differ significantly between the obese group (77.2 and 79.4 %, respectively) and the nonobese group (83.4 and 84.9 %, respectively).
Conclusions
Postoperative complications and long-term oncologic outcomes were similar in obese and nonobese patients who underwent laparoscopic colectomy for colon cancer in this hospital.
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References
Wexner SD, Cohen SM, Johansen OB, Nogueras JJ, Jagelman DG. Laparoscopic colorectal surgery: a prospective assessment and current perspective. Br J Surg. 1993;80:1602–5.
Milsom JW, Böhm B, Hammerhofer KA, Fazio V, Steiger E, Elson P. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a Preliminary Report. J Am Coll Surg. 1998;187:46–54.
Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, Visa J. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359:2224–9.
Hotta T, Yamaue H. Laparoscopic surgery for rectal cancer: review of published literature 2000–2009. Surg Today. 2011;41:1583–91.
Raut V, Uemoto S. Management of ABO-incompatible living-donor liver transplantation: past and present trends. Surg Today. 2011;41:317–22.
Pikarsky AJ, Saida Y, Yamaguchi T, Martinez S, Chen W, Weiss EG, Nogueras JJ, Wexner SD. Is obesity a high-risk factor for laparoscopic colorectal surgery? Surg Endosc. 2002;16:855–8.
Senagore AJ, Delaney CP, Madboulay K, Brady KM, Fazio VW. Laparoscopic colectomy in obese and nonobese patients. J Gastrointest Surg. 2003;7:558–61.
Delaney CP, Pokala N, Senagore AJ, Casillas S, Kiran RP, Brady KM, Fazio VW. Is laparoscopic colectomy applicable to patients with body mass index >30? A case-matched comparative study with open colectomy. Dis Colon Rectum. 2005;48:975–81.
Lascano CA, Kaidar-Person O, Szomstein S, Rosenthal R, Wexner SD. Challenges of laparoscopic colectomy in the obese patients: a review. Am J Surg. 2006;192:357–65.
Blee TH, Belzer GE, Lambert PJ. Obesity: is there an increase in perioperative complications in those undergoing elective colon and rectal resection for carcinoma? Am Surg. 2002;68:163–6.
Choban PS, Flancbaum L. The impact of obesity on surgical outcomes: a review. J Am Coll Surg. 1997;185:593–603.
Garrow JS, Hastings EJ, Cox AG, North WRS, Gibson M, Thomas TM, Meade TW. Obesity and postoperative complications of abdominal operation. BMJ. 1998;297:181.
Schwandner O, Farke S, Schiedeck TH, Bruch HP. Laparoscopic colorectal surgery in obese and nonobese patients. Do differences in body mass indices lead to different outcomes? Surg Endosc. 2004;18:1452–6.
Gervaz P, Pikarsky A, Utech M, Secic M, Efron J, Belin B, Jain A, Wexner S. Converted laparoscopic colorectal surgery. A meta-analysis. Surg Endosc. 2001;15:827–32.
WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Health Communications Australia Pty Ltd, 2000.
Nakamura T, Kokuba Y, Mitomi H, Sato T, Ozawa H, Ihara A, Watanabe M. New technique of laparoscopic colectomy with the lap disc and a 5-mm flexible scope. Surg Endosc. 2006;20:1501–3.
Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10:44–52.
Schwandner O, Schiedeck TH, Bruch H. The role of conversion in laparoscopic colorectal surgery: do predictive factors exist? Surg Endosc. 1999;13:151–6.
Abir F, Bell R. Assessment and management of the obese patient. Crit Care Med. 2004;32:S87–91.
Juvin P, Lavaut E, Dupont H, Lefevre P, Demetriou M, Dumoulin JL, Desmonts JM. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg. 2003;97:595–600.
Conflict of interest
Dr. Sato received lecture fees from Chugai Pharmacy and Dr. Watanabe received lecture fees from Ethicon Endo-Surgery and Coviden Japan. Dr. Nakamura, Dr. Miura, Dr. Ikeda, Dr. Naito, Dr. Ogura, Dr. Tsutsui and Dr. Mitomi have no conflict of interest.
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Nakamura, T., Miura, H., Ikeda, A. et al. Laparoscopic surgery for colon cancer in obese patients: a case-matched control study. Surg Today 43, 763–768 (2013). https://doi.org/10.1007/s00595-012-0352-0
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DOI: https://doi.org/10.1007/s00595-012-0352-0