Published online Oct 27, 2015. doi: 10.4240/wjgs.v7.i10.261
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.
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.