Short- and long-term impact of body mass index on laparoscopic rectal cancer surgery.
Colorectal Dis
; 15(4): 463-9, 2013 Apr.
Article
em En
| MEDLINE
| ID: mdl-23534683
ABSTRACT
AIM:
Obesity is associated with increased technical difficulty in laparoscopic surgery. However, its impact has been measured mainly for colectomy but not specifically for rectal excision. The aim of the study was to assess the impact of body mass index (BMI) on technical feasibility and oncological outcome of laparoscopic rectal excision for cancer.METHOD:
A total of 490 patients treated by laparoscopic rectal excision for rectal cancer from January 1999 to June 2010 were included. Seventy per cent had had preoperative radiochemotherapy. Patients were separated into four groups according to BMI (kg/m(2) ) < 20, 20-25, 25-30 and ≥ 30. The impact of BMI on conversion, surgical morbidity, quality of excision (Quirke mesorectal grade and circumferential resection margin) and long-term oncological outcome was determined.RESULTS:
Among the 490 patients BMI was < 20 in 43, 20-25 in 223, 25-30 in 177 and ≥ 30 in 47. Mortality (overall 1%) and morbidity (overall 19%) were similar between the groups. Conversion in the four groups was 5%, 14%, 23% and 32% (P = 0.001). The quality of mesorectal excision and circumferential margins did not differ between the groups. The 5-year local recurrence rates (0%, 4.6%, 5.3% and 5.9% respectively; P = 0.823) and the overall and disease-free survival were not significantly influenced by BMI.CONCLUSION:
In laparoscopic surgery for rectal cancer, BMI influenced the risk of conversion but not surgical morbidity, quality of surgery and survival. This suggests that all patients, including obese patients, are suitable for laparoscopic surgery.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Adenocarcinoma
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Índice de Massa Corporal
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Laparoscopia
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Complicações Intraoperatórias
/
Recidiva Local de Neoplasia
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Colorectal Dis
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
França