Outcomes of laparoscopic colorectal surgery in obese and nonobese patients: a case-matched study of 180 patients

Am J Surg. 2009 Sep;198(3):450-5. doi: 10.1016/j.amjsurg.2008.09.022. Epub 2009 Mar 12.

Abstract

Background: Because it has been suggested that obese patients may be at higher risk of morbidity and mortality after surgery, we conducted a prospective case-matched study to compare outcomes of elective laparoscopic colorectal surgery in obese and nonobese patients.

Methods: Sixty-two consecutive nonselected obese patients (body mass index > or =30 kg/m(2)) were matched with 118 nonobese patients. Postsurgical mortality and morbidity were defined as in-hospital death and complications.

Results: Cardiopulmonary comorbidities were significantly more frequent in obese compared with nonobese patients (44% vs 24%, P < .01). Obesity was significantly associated with increased mean operating time (268 +/- 74 min vs 232 +/- 59 min, P < .001), and conversion rate (32% vs 14%, P < .01). The mortality rate was nil. The overall postsurgical morbidity rate (31% vs 19%, P = not significant) and mean hospital stay (11 +/- 10 days vs 9 +/- 8 days, P = not significant) were similar in obese and nonobese patients.

Conclusions: The results of this large case-matched study suggest that laparoscopic approach for colorectal surgery is feasible and safe in obese patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Case-Control Studies
  • Chi-Square Distribution
  • Colonic Diseases / surgery*
  • Female
  • Humans
  • Laparoscopy*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity / complications*
  • Postoperative Complications
  • Prospective Studies
  • Rectal Diseases
  • Risk Factors
  • Time Factors
  • Treatment Outcome