The impact of body mass index on perioperative outcomes after laparoscopic colorectal surgery

Abstract

Laparoscopic colorectal surgery has gained increasing attention during the past 20 years. Surgeons today are more often confronted with obese patients. Therefore, it is timely to investigate the feasibility and safety of laparoscopic surgery for colorectal disease in obese patients. This study included 65 patients with colorectal disease who underwent laparoscopic surgery, between January 2009 and January 2014, at Kurume University Hospital. We divided the patients in this study into two groups based on their body mass index (BMI): <25 kg⁄m2 (non-obese group) and ≥ 25 kg/m2 (obese group). We assessed baseline characteristics and surgical outcomes, and these were compared between the non-obese group and the obese group. There were 53 patients in the non-obese group, and 12 patients in the obese group. There was no significant difference between the two groups of patients with regard to age, sex, co-morbidity, tumor location, tumor node metastasis (TNM) stage, tumor size and serum carcinoembryonic antigen (CEA) level. The duration of the operation was longer (by about 49 mins) for obese patients than non-obese patients. The conversion rate, amount of blood loss, number of lymph nodes resected, and duration of postoperative hospitalinsertion were each similar between the two groups. There was no significant difference between the two groups with regard to the overall incidence of postoperative complications; however, the incidence of incisional hernia tended to be more frequent in obese patients. There was no mortality in the two groups. Laparoscopic colorectal surgery is technically feasible and safe for obese patients. However, obesity is associated with longer duration and with higher risk of incisional hernia. Our findings suggest that BMI may not be an accurate estimate of visceral fat, and further studies may be useful for understanding the impact of obesity.