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Yamashita M, Tominaga T, Nonaka T, Fukda A, Moriyama M, Oyama S, Tanaka K, Hamada K, Araki M, Sumida Y, Takeshita H, Hisanaga M, Fukuoka H, Wada H, Tou K, Sawai T, Nagayasu T. Impact of obesity on short-term outcomes of laparoscopic colorectal surgery for Japanese patients with colorectal cancer: A multicenter study. Asian J Endosc Surg 2021; 14:432-442. [PMID: 33111467 DOI: 10.1111/ases.12888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The impact of obesity on short-term outcomes after laparoscopic colorectal surgery (LAC) in Asian patients is unclear. The purpose of the present multicenter study was to evaluate the safety and feasibility of LAC in obese Japanese patients. METHODS We retrospectively reviewed 1705 patients who underwent LAC between April 2016 and February 2019. Patients were classified according to body mass index (BMI): non-obese (BMI < 25 kg/m2 , n = 1335), obese I (BMI 25-29.9 kg/m2 , n = 313), and obese II (BMI ≥30 kg/m2 , n = 57). Clinical characteristics and surgical outcomes were compared among the three groups. RESULTS The proportion of patients with comorbidities (non-obese, 58.1%; obese I, 69.6%; obese II, 75.4%; P < .001) and median operation time (non-obese, 224 minutes; obese I, 235 minutes; obese II, 258 minutes; P = .004) increased significantly as BMI increased. The conversion rate was similar among the groups (P = .715). Infectious complications were significantly high in obese II patients (non-obese, 10.4%; obese I, 8.3%; obese II, 28.1%; P < .001). Multivariate analysis revealed that in obese II patients, BMI was an independent predictive factor of infectious postoperative complications (odds ratio 2.648; 95% confidence interval, 1.421-4.934; P = .002). CONCLUSION LAC has an increased risk of postoperative infectious complications in obese II patients, despite improvements in surgical technique. Management of obese II colorectal cancer patients requires meticulous perioperative management.
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Affiliation(s)
- Mariko Yamashita
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.,Department of Surgery, Saiseikai Nagasaki Hospital, Nagasaki, Japan
| | - Tetsuro Tominaga
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takashi Nonaka
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Akiko Fukda
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Masaaki Moriyama
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Syosaburo Oyama
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kenji Tanaka
- Department of Surgery, Saiseikai Nagasaki Hospital, Nagasaki, Japan
| | - Kiyoaki Hamada
- Department of Surgery, Sasebo City General Hospital, Nagasaki, Japan
| | - Masato Araki
- Department of Surgery, Sasebo City General Hospital, Nagasaki, Japan
| | - Yorihisa Sumida
- Department of Surgery, Sasebo City General Hospital, Nagasaki, Japan
| | - Hiroaki Takeshita
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Makoto Hisanaga
- Department of Surgery, Isahaya General Hospital, Nagasaki, Japan
| | | | - Hideo Wada
- Department of Surgery, Ureshino Medical Center, Saga, Japan
| | - Kazuo Tou
- Department of Surgery, Ureshino Medical Center, Saga, Japan
| | - Terumitsu Sawai
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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