Previous reports comparing outcomes of laparoscopic colectomy in obese vs nonobese patients from small, single-institution series have included few obese patients and have shown variable results, some suggesting that obesity has no impact on outcomes.
Dr Conan Mustain and colleagues determined whether any intraoperative or short-term postoperative outcome of laparoscopic colectomy is affected by obesity, independent of other variables.
The research team performed a retrospective study comparing outcomes of patients undergoing laparoscopic colectomy grouped by BMI.
The team queried American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files for patients undergoing nonemergent, laparoscopic colectomy from 2005 through 2008.
Cases with a secondary procedure were excluded.
|Significant differences were found among BMI classes for length of stay|
|Diseases of the Colon & Rectum|
The research team analyzed operative time, length of stay, transfusion requirement, reoperation within 30 days, wound complications, pulmonary complications, sepsis/septic shock, deep venous thrombosis, renal failure/insufficiency, and death.
In an analysis of 9693 patients, significant differences were found among BMI classes for length of stay, operative time, and wound complication.
Operative time correlated with BMI class independent of other variables, whereas length of stay did not.
After adjustment of all available variables, the team observed that obesity remained an independent risk factor for wound complication, and the odds ratios increased with increasing obesity class.
Dr Mustain's team commented, "These data confirm that, in patients undergoing laparoscopic colectomy, obesity is an independent risk factor for wound complications."
"Although obesity also increases operative time, the effect of obesity on wound complications remains after adjustment for this and other risk factors."