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Impact of obesity on short-term results of laparoscopic rectal cancer resection

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Abstract

Introduction

The influence of obesity [body mass index (BMI) ≥ 30 kg/m2] on the outcome of laparoscopic colorectal surgery remains controversial. The complexity of rectal laparoscopic resections requires a specific assessment of the impact of obesity on the feasibility and short-term results of the surgery.

Methods

Between February 2002 and May 2007, 210 laparoscopic mesorectal excisions were performed. Demographic, oncologic and perioperative data were entered in a prospective database. Twenty-four patients (11.4%) with BMI over 30 kg/m2 formed the obese group (OG). The outcomes in the OG and the nonobese group (NOG) were compared.

Results

There were significantly more American Society of Anesthesiologists (ASA) score 3 patients (26% in OG versus 9% in NOG; p = 0.03) in the obese group. Obese patients experienced longer operative times (513 min in OG vs. 421 min in NOG; p < 0.01) and more frequent conversion to laparotomy (46% in OG vs. 12% in NOG; p < 0.001). Morbidity grade 1 was higher in the obese group (29.2% vs. 9.7% in NOG; p = 0.01), but there was no difference in regards to morbidity grade 2 or more (33.3% in OG vs. 32.3% in NOG). In addition, conversion to laparotomy among the obese did not increase significantly morbidity grade 2 or higher (5 of 11 for OG converted vs. 3 of 13 for OG nonconverted; p = 0.39). Regarding the oncological parameters (e.g. number of lymph nodes removed, distal and lateral margins) there was no difference between groups.

Conclusion

Obesity increases operative duration and conversion rate of rectal laparoscopic resection for cancer. Although obesity is associated with a worse preoperative evaluation, there is no increase in relevant morbidity and no impairment of oncological safety.

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Authors and Affiliations

  1. Department of Surgical Oncology, Institut Paoli Calmettes, Université de la Méditerranée, 232 Boulevard Sainte Marguerite, Marseille, 13009, France

    Thierry Bège, Bernard Lelong, Olivier Turrini, Jérome Guiramand & Jean-Robert Delpero

  2. Department of Anesthesiology, Institut Paoli Calmettes, Université de la Méditerranée, Marseille, France

    Daniel Francon

Authors
  1. Thierry Bège
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  2. Bernard Lelong
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  3. Daniel Francon
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  4. Olivier Turrini
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  5. Jérome Guiramand
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  6. Jean-Robert Delpero
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Correspondence to Thierry Bège.

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Bège, T., Lelong, B., Francon, D. et al. Impact of obesity on short-term results of laparoscopic rectal cancer resection. Surg Endosc 23, 1460–1464 (2009). https://doi.org/10.1007/s00464-008-0266-5

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  • DOI: https://doi.org/10.1007/s00464-008-0266-5

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