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Short- and long-term impact of body mass index on laparoscopic rectal cancer surgery.
MedLine Citation:
PMID:  23534683     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Q Denost; L Quintane; E Buscail; M Martenot; C Laurent; E Rullier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  15     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  463-9     Citation Subset:  IM    
Copyright Information:
© 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
CHU Bordeaux, Saint-Andre Hospital, Digestive Surgery, Bordeaux, F-33075, France Bordeaux Segalen University, Bordeaux, F-33076, France.
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