Obesity as a determinant of perioperative and postoperative outcome in patients following colorectal cancer surgery: A population-based study (2009–2016)
| Autor: | Michel W.J.M. Wouters, Youri Q M Poelemeijer, Robin Detering, Niki Lijftogt, Rob A. E. M. Tollenaar, Marta Fiocco |
|---|---|
| Přispěvatelé: | AGEM - Digestive immunity, CCA - Cancer Treatment and Quality of Life, AGEM - Re-generation and cancer of the digestive system, Graduate School, Surgery |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Colorectal cancer business.industry Population Postoperative complication General Medicine Perioperative 030230 surgery Overweight medicine.disease Obesity 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Internal medicine medicine Postoperative outcome Surgery medicine.symptom Underweight education business |
| Zdroj: | European journal of surgical oncology, 44(12), 1849-1857. W.B. Saunders Ltd |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2018.05.027 |
| Popis: | Background: Obesity is an increasing problem worldwide that can influence perioperative and postoperative outcomes. However, the relationship between obesity and treatment-related perioperative and short-term postoperative morbidity after colorectal resections is still subject to debate. Study: Patients were selected from the DCRA, a population-based audit including 83 hospitals performing colorectal cancer (CRC) surgery. Data regarding primary resections between 2009 and 2016 were eligible for analyses. Patients were subdivided into six categories: underweight, normal weight, overweight and obesity class I, II and III. Results: Of 71,084 patients, 17.7% with colon and 16.4% with rectal cancer were categorized as obese. Significant differences were found for the 30-day overall postoperative complication rate (p < 0.001), prolonged hospitalization (p < 0.001) and readmission rate (colon cancer p < 0.005; rectal cancer p < 0.002) in obese CRC patients. Multivariate analysis identified BMI ≥30 kg/m2 as independent predictor of a complicated postoperative course in CRC patients. Furthermore, obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate. No significant differences in performance were observed in postoperative outcomes of morbidly obese CRC patients between hospitals performing bariatric surgery and hospitals that did not. Conclusion: The real-life data analysed in this study reflect daily practice in the Netherlands and identify obesity as a significant risk factor in CRC patients. Obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate in obese CRC patients. No differences were observed between hospitals performing bariatric surgery and hospitals that did not. |
| Databáze: | OpenAIRE |
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