The influence of obesity on short- and long-term outcomes after laparoscopic surgery for colon cancer: A case-matched study of 152 patients
| Autor: | Parul J. Shukla, Koiana Trencheva, Raghava S. Pavoor, Tomoki Makino, Changhua Zhuo, Jeffrey W. Milsom, Francesco Rubino |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Laparoscopic surgery medicine.medical_specialty Time Factors medicine.medical_treatment Operative Time Kaplan-Meier Estimate Gastroenterology Disease-Free Survival Body Mass Index Internal medicine medicine Humans Obesity Survival rate Colectomy Aged business.industry Hazard ratio Perioperative Middle Aged Colorectal surgery Confidence interval Surgery Treatment Outcome Case-Control Studies Colonic Neoplasms Female Laparoscopy business Body mass index |
| Zdroj: | Surgery. 156:661-668 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2014.03.023 |
| Popis: | Despite the increasing prevalence of obesity and colonic diseases, the impact of obesity on short-term and oncologic outcomes of laparoscopic colorectal surgery still remains unclear.Seventy-six consecutive obese patients with body mass index (BMI) ≥30 kg/m(2) who underwent laparoscopic colectomy were matched with 76 nonobese patients with BMI30 kg/m(2). Perioperative parameters and oncologic outcomes were analyzed in the two groups.Obesity was associated with greater operative time (obese vs nonobese, 182 ± 59 vs 157 ± 55 min, P = .0084) and multivariate analysis identified BMI (hazard ratio 2.11, 95% confidence interval 0.64-3.56, P = .0049) as an independent predicting factor for operative time together with cancer location (hazard ratio 28.6, 95% confidence interval 14.62-42.51, P .0001). Obesity had no adverse influence on overall morbidity (25 vs 21%, P = .563), however, or postoperative duration of stay (median 6.0 vs 5.5 days, P = .22). Furthermore, the rate of conversion to open procedure was similar between the two groups (9 vs 9%, P .99). Regarding oncologic outcomes, there was no statistical difference in overall and disease-free survival between the two groups (5-year overall survival rate 86 vs 89%, P = .72, 5-year disease survival rate 70 vs 77%, P = .70).Laparoscopic colonic resection, when performed for selected patients, appears to be a safe and reasonable option in obese patients with colon cancer resulting in similar short-term and oncologic outcomes as nonobese patients. |
| Databáze: | OpenAIRE |
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