Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2015; 7(10): 261-266
Published online Oct 27, 2015. doi: 10.4240/wjgs.v7.i10.261
Obese patients have similar short-term outcomes to non-obese in laparoscopic colorectal surgery
Manish Chand, Henry D De’Ath, Muhammed Siddiqui, Chetanya Mehta, Shahnawaz Rasheed, James Bromilow, Tahseen Qureshi
Manish Chand, Henry D De’Ath, Muhammed Siddiqui, Chetanya Mehta, Shahnawaz Rasheed, James Bromilow, Tahseen Qureshi, Department of Surgery, Poole General Hospital, Poole BH15 2JB, United Kingdom
Author contributions: All authors contributed to this manuscript.
Institutional review board statement: This study has been reviewed and approved by the Colorectal Department of Poole General Hospital.
Clinical trial registration statement: N/A.
Informed consent statement: N/A.
Conflict-of-interest statement: None of the authors have any conflict of interest.
Data sharing statement: N/A.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Manish Chand, Laparoscopic Fellow in GI Surgery, Department of Surgery, Poole General Hospital, Longfleet Road, Poole BH15 2JB, United Kingdom.
Telephone: +44-1202-442323
Received: April 5, 2015
Peer-review started: April 7, 2015
First decision: July 17, 2015
Revised: July 19, 2015
Accepted: August 20, 2015
Article in press: August 21, 2015
Published online: October 27, 2015

AIM: To determine whether obese patients undergoing laparoscopic surgery within an enhanced recovery program had worse short-term outcomes.

METHODS: A prospective study of consecutive patients undergoing laparoscopic colorectal resection was carried out between 2008 and 2011 in a single institution. Patients were divided in groups based on body mass index (BMI). Short-term outcomes including operative data, length of stay, complications and readmission rates were recorded and compared between the groups. Continuous data were analysed using t-test or one-way Analysis of Variance. χ2 test was used to compare categorical data.

RESULTS: Two hundred and fifty four patients were included over the study period. The majority of individuals (41.7%) recruited were of a healthy weight (BMI < 25), whilst 50 patients were classified as obese (19.6%). Patients were matched in terms of the presence of co-morbidities and previous abdominal surgery. Obese patients were found to have a statistically significant difference in The American Society of Anesthesiologists grade. Length of surgery and intra-operative blood loss were no different according to BMI.

CONCLUSION: Obesity (BMI > 25) does not lead to worse short-term outcomes in laparoscopic colorectal surgery and therefore such patients should not be precluded from laparoscopic surgery.

Keywords: Laparoscopic surgery, Colorectal cancer, Obese: body mass index, Outcomes

Core tip: Laparoscopic colorectal surgery for cancer can be safely performed in obese patients without an increase in adverse events or outcomes. Patients should not be precluded from laparoscopy in such cases based on their body mass index. However it is important for the team to assess patients pre-operatively to decide on whether additional or more intensive peri-operative care is needed to ensure optimal outcomes.