Society for Surgery of the Alimentary Tract
Back to 2006 Program and Abstracts
The Impact of Obesity on Technical Feasibility and Postoperative Outcomes of Laparoscopic Colectomy
Marc Zerey, Kent W. Kercher, Amy E. Lincourt, Dimitrios Stefanidis, Timothy S. Kuwada, Keith S. Gersin, B Todd Heniford; Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC

Background The influence of obesity on laparoscopic surgical outcomes is not clearly defined. We present the effects of obesity on patient outcomes following laparoscopic colectomy. Methods We retrospectively surveyed all laparoscopic colectomies performed at our institution from 1998 to 2005. Patients were categorized as obese (body mass index (BMI)>30 kg/m2) or non-obese (BMI≤30kg/m2). Data obtained included demographics, perioperative data, length of stay (LOS), complications, and charges. Standard statistical methods were used to determine significance (P<0.05). Results A total of 224 patients were included for analysis, 63(28.1%) of which were obese. Gender distribution was similar in both groups but obese patients were younger than non-obese (male gender: 51.5% vs 48.5%; P=0.61; age 53.7±16.1 years vs 59.5±12.8 years; P=0.01) and more likely to have comorbidities (58.7% vs 39.1%; P=0.01). Mean OR time and conversion rates were not significantly different (OR time: obese 195.5±54.6 min, non-obese 184.0±53.3 min; P=0.19; conversions: obese: 14.3%, non-obese: 12.4%; P=0.71). In patients undergoing colectomy for cancer, proximal margin, distal margin, length of bowel resected and lymph nodes resected did not differ significantly between obese and non-obese groups (proximal margin: 8.3±7.6 vs 11.4±12.8 cm; P=0.20; distal margin: 7.5±4.7 vs 11.1±11.5cm; P=0.33; length of bowel resected: 18.9±8.3 cm vs 21.6±13.3 cm; P=0.36; lymph nodes resected: 14.7±8.0 vs 17.5±12.1 nodes; P=0.55). Complication rates, LOS, and total charges were not statistically different between obese and non-obese groups (Overall complications: 15.9% vs 9.9%; P=0.21; pneumonia: 1.59% vs 1.86%; P=1.0; wound infection: 11.1% vs 5.6% P=0.15; LOS: 5.9 days vs 6.1 days; P=0.57; total charges: ,494.87 vs ,857.39; P=0.81). Conclusions Despite higher comorbidity rates and operating times in obese patients, short-term outcomes following laparoscopic colectomy are similar to the non-obese. Obesity should not be a contraindication to laparoscopic colectomy.


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