Obesity Increases Risks of Hepatic Resection
Abstracts
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Purpose: This study examines the influence of obesity on outcome following hepatectomy in patients with metastatic colorectal cancer. Methods: Peri-operative results of 736 patients resected between 7/89 and 7/98 were analyzed according to body mass index of each patient (BMI = weight (kg)/height (m2)). Obesity is defined as a BMI ? 30. Operations performed, were 189 trisegmentectomies, 254 lobectomies and 293 resections of less than a lobe. Results: Overall mortality was 2% and complication rate 35%. Obesity was significantly associated with increased complications (p = 0.05, Chi-square), with increased operative time and blood loss (OpTime, p = 0.05, blood loss, p = 0.05, Mann-Whitney U, see table). When considering only resections of a lobe of liver or more, the results are more impressive (OpTime, non-obese 260?5 vs. 290?12, p = 0.03 and Blood loss, non-obese 1000?60 vs 1900?330, p = 0.01). By multivariate analysis (binary logistic) using age >65, ?lobectomy, ?1 liter blood loss, and obesity as co-variates, obesity remains an independent predictor (p = 0.02) of complications. Obese patients have 1.6 times increased risk of complications. Conclusion: In addition to tumor biology, surgical technique and cardiopulmonary status, BMI should be used in assessment of patients for hepatic resection. |
