Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 3/2012

01-03-2012

Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis

Authors: Yanming Zhou, Lupeng Wu, Xiudong Li, Xiurong Wu, Bin Li

Published in: Surgical Endoscopy | Issue 3/2012

Login to get access

Abstract

Background

Obese patients are generally believed to be at increased risk for surgery compared with those who are not obese. A meta-analysis was performed to assess the outcomes of laparoscopic colorectal surgery in obese and nonobese patients.

Methods

A systematic literature search from inception to June 2011 was performed. Pooled odds ratios (OR) and weighted mean differences (WMD) with 95% confidence intervals (95% CI) were calculated using the fixed effects model or random effects model.

Results

Eight observational studies identified and matched the selection criteria. Conversion rates (OR: 2.31, 95% CI: 1.74–3.08), operating time (WMD: 15.33, 95% CI: 1.81–28.85), and postoperative morbidity (OR: 2.11; 95% CI: 1.3–3.42) were all significantly increased in the obese group. Length of hospital stay and mortality were similar in both groups. For patients with cancer, there was no difference between groups for the number of harvested nodes and length of specimen.

Conclusions

Obesity is associated with increased conversion rate, operating time, and postoperative morbidity of laparoscopic colorectal surgery but does not affect surgical safety or oncological security.
Literature
1.
Lascano CA, Kaidar-Person O, Szomstein S, Rosenthal R, Wexner SD (2006) Challenges of laparoscopic colectomy in the obese patient: a review. Am J Surg 192:357–365PubMedCrossRef
2.
Benoist S, Panis Y, Alves A, Valleur P (2000) Impact of obesity on surgical outcomes after colorectal resection. Am J Surg 179:275–281PubMedCrossRef
3.
4.
Senagore AJ, Delaney CP, Madboulay K, Brady KM, Fazio VW (2003) Laparoscopic colectomy in obese and nonobese patients. J Gastrointest Surg 7:558–561PubMedCrossRef
5.
Leroy J, Ananian P, Rubino F, Claudon B, Mutter D, Marescaux J (2005) The impact of obesity on technical feasibility and postoperative outcomes of laparoscopic left colectomy. Ann Surg 241:69–76PubMed
6.
Pikarsky AJ, Saida Y, Yamaguchi T, Martinez S, Chen W, Weiss EG, Nogueras JJ, Wexner SD (2002) Is obesity a high risk factor for laparoscopic colorectal surgery? Surg Endosc 16:855–858PubMedCrossRef
7.
Schwandner O, Farke S, Schiedeck TH, Bruch HP (2004) Laparoscopic colorectal surgery in obese and nonobese patients: do differences in body mass indices lead to different outcomes? Surg Endosc 18:1452–1456PubMedCrossRef
8.
Dostalik J, Martinek L, Vavra P, Andel P, Gunka I, Gunkova P (2005) Laparoscopic colorectal surgery in obese patients. Obes Surg 15:1328–1331PubMedCrossRef
9.
Kamoun S, Alves A, Bretagnol F, Lefevre JH, Valleur P, Panis Y (2009) Outcomes of laparoscopic colorectal surgery in obese and nonobese patients: a case-matched study of 180 patients. Am J Surg 198:450–455PubMedCrossRef
10.
Athanasiou T, Al-Ruzzeh S, Kumar P, Crossman MC, Amrani M, Pepper JR, Del Stanbridge R, Casula R, Glenville B (2004) Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Ann Thorac Surg 77:745–753PubMedCrossRef
11.
World Health Organ Tech Rep Ser (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation 894:i–xii, 1–253
12.
Sakamoto K, Niwa S, Tanaka M, Goto M, Sengoku H, Tomiki Y (2007) Influence of obesity on the short-term outcome of laparoscopic colectomy for colorectal cancer. J Minim Access Surg 3:98–103PubMedCrossRef
13.
Nitori N, Hasegawa H, Ishii Y, Endo T, Kitagawa Y (2009) Impact of visceral obesity on short-term outcome after laparoscopic surgery for colorectal cancer: a single Japanese center study. Surg Laparosc Endosc Percutan Tech 19:324–327PubMedCrossRef
14.
Tuech JJ, Regenet N, Hennekinne S, Pessaux P, Bergamaschi R, Arnaud JP (2001) Laparoscopic colectomy for sigmoid diverticulitis in obese and nonobese patients: a prospective comparative study. Surg Endosc 15:1427–1430PubMed
15.
Scheidbach H, Benedix F, Hügel O, Kose D, Köckerling F, Lippert H (2008) Laparoscopic approach to colorectal procedures in the obese patient: risk factor or benefit? Obes Surg 18:66–70PubMedCrossRef
16.
Park JW, Lim SW, Choi HS, Jeong SY, Oh JH, Lim SB (2010) The impact of obesity on outcomes of laparoscopic surgery for colorectal cancer in Asians. Surg Endosc 24:1679–1685PubMedCrossRef
17.
Canedo J, Pinto RA, Regadas S, Regadas FS, Rosen L, Wexner SD (2010) Laparoscopic surgery for inflammatory bowel disease: does weight matter? Surg Endosc 24:1274–1279PubMedCrossRef
18.
Karahasanoglu T, Hamzaoglu I, Baca B, Aytac E, Kirbiyik E (2011) Impact of increased body mass index on laparoscopic surgery for rectal cancer. Eur Surg Res 46:87–93PubMedCrossRef
19.
Khoury W, Kiran RP, Jessie T, Geisler D, Remzi FH (2010) Is the laparoscopic approach to colectomy safe for the morbidly obese? Surg Endosc 24:1336–1340PubMedCrossRef
20.
Gendall KA, Raniga S, Kennedy R, Frizelle FA (2007) The impact of obesity on outcome after major colorectal surgery. Dis Colon Rectum 50:2223–2237PubMedCrossRef
21.
Bège T, Lelong B, Francon D, Turrini O, Guiramand J, Delpero JR (2009) Impact of obesity on short-term results of laparoscopic rectal cancer resection. Surg Endosc 23:1460–1464PubMedCrossRef
22.
Singh A, Girivasan M, Pawa N, Riaz AA, Hendricks JB, Motson RW (2010) Laparoscopic colorectal cancer surgery in obese patients. Colorectal Dis [Epub ahead of print]
23.
Schwandner O, Schiedeck TH, Bruch H (1999) The role of conversion in laparoscopic colorectal surgery: do predictive factors exist? Surg Endosc 13:151–156PubMedCrossRef
24.
Toma O, Suntrup P, Stefanescu A, London A, Mutch M, Kharasch E (2011) Pharmacokinetics and tissue penetration of cefoxitin in obesity: implications for risk of surgical site infection. Anesth Analg [Epub ahead of print]
25.
Allaire AD, Fisch J, McMahon MJ (2000) Subcutaneous drain vs. suture in obese women undergoing cesarean delivery. A prospective, randomized trial. J Reprod Med 45:327–331PubMed
26.
Soisson AP, Olt G, Soper JT, Berchuck A, Rodriguez G, Clarke-Pearson DL (1993) Prevention of superficial wound separation with subcutaneous retention sutures. Gynecol Oncol 51:330–334PubMedCrossRef
27.
Dhadwal K, Al-Ruzzeh S, Athanasiou T, Choudhury M, Tekkis P, Vuddamalay P, Lyster H, Amrani M, George S (2007) Comparison of clinical and economic outcomes of two antibiotic prophylaxis regimens for sternal wound infection in high-risk patients following coronary artery bypass grafting surgery: a prospective randomised double-blind controlled trial. Heart 93:1126–1133PubMedCrossRef
28.
Alexander JW, Rahn R, Goodman HR (2009) Prevention of surgical site infections by an infusion of topical antibiotics in morbidly obese patients. Surg Infect (Larchmt) 10:53–57CrossRef
29.
Svatek RS, Fisher MB, Williams MB, Matin SF, Kamat AM, Grossman HB, Nogueras-González GM, Urbauer DL, Dinney CP (2010) Age and body mass index are independent risk factors for the development of postoperative paralytic ileus after radical cystectomy. Urology 76:1419–1424PubMedCrossRef
30.
Pelosi P, Croci M, Ravagnan I, Vicardi P, Gattinoni L (1996) Total respiratory system, lung, and chest wall mechanics in sedated-paralyzed postoperative morbidly obese patients. Chest 109:144–151PubMedCrossRef
31.
Pelosi P, Croci M, Ravagnan I, Tredici S, Pedoto A, Lissoni A, Gattinoni L (1998) The effects of body mass on lung volumes, respiratory mechanics, and gas exchange during general anesthesia. Anesth Analg 87:654–660PubMed
32.
33.
Damia G, Mascheroni D, Croci M, Tarenzi L (1988) Perioperative changes in functional residual capacity in morbidly obese patients. Br J Anaesth 60:574–578PubMedCrossRef
34.
von Ungern-Sternberg BS, Regli A, Schneider MC, Kunz F, Reber A (2004) Effect of obesity and site of surgery on perioperative lung volumes. Br J Anaesth 92:202–207CrossRef
35.
Delaney CP, Pokala N, Senagore AJ, Casillas S, Kiran RP, Brady KM, Fazio VW (2005) Is laparoscopic colectomy applicable to patients with body mass index >30? A case-matched comparative study with open colectomy. Dis Colon Rectum 48:975–981PubMedCrossRef
36.
Protani M, Coory M, Martin JH (2010) Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123:627–635PubMedCrossRef
Metadata
Title
Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis
Authors
Yanming Zhou
Lupeng Wu
Xiudong Li
Xiurong Wu
Bin Li
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 3/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-1952-2

Other articles of this Issue 3/2012

Surgical Endoscopy 3/2012 Go to the issue

Letter to the Editor--Reply

Combined pretherapeutic endoscopic and laparoscopic ultrasonography may predict survival of patients with upper gastrointestinal tract cancer

OriginalPaper

Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer: a matched cohort study

Dynamic Manuscript

Laparoscopic intracorporeal knot tying using a novel device

OriginalPaper

Surgical outcomes of laparoscopy-assisted gastrectomy versus open gastrectomy for gastric cancer: a case-control study

Letter to the Editor

Incarcerated hiatal hernia after robot-assisted esophagectomy: transhiatal versus thoracoscopic approach

New Technology

Totally transvaginal resection of the descending colon in an experimental model