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Does obesity increase early postoperative complications after laparoscopic colorectal surgery?

This month's issue of Surgical Endoscopy compares postoperative complication rates between obese and nonobese patients undergoing laparoscopic colorectal surgery.

News image

Laparoscopic colorectal surgery has several advantages over open surgery, but laparoscopic colorectal surgery has been associated with a higher rate of postoperative complications among obese patients.

The prevalence of obesity in Chile is increasing, up to 25% in 2010, suggesting that a higher percentage of patients undergoing laparoscopic colorectal surgery will be obese.

Dr Camila Estay and colleagues compared postoperative complication rates between obese and nonobese patients undergoing laparoscopic colorectal surgery.

The team evaluated case and control patients in a prospectively maintained laparoscopic colorectal surgery database who underwent laparoscopic colorectal surgery between 2007 and 2012 at Clinica Las Condes, Santiago, Chile.

Obese and nonobese patients were paired by gender, age, American Society of Anesthesiologists class, preoperative diagnosis, and type of surgery.

Intraoperative complications and postoperative complications were documented up to 30 days.

Postoperative complications occurred in 25% of obese patients
Surgical Endoscopy

The team classified severity of each postoperative complication by Clavien–Dindo score.

In this study, 449 patients who underwent laparoscopic colorectal surgery during the study period were identified.

The study paired 53 obese patients with 53 nonobese patients.

The research team found that the median age was 55 years in the obese group, and 57 years in the nonobese group, and 60% of the patients in both groups were men.

The team showed postoperative complications in 25% of obese, and 28% of nonobese patients.

Stratified by severity of postoperative complications, the 2 groups were similar.

The 2 groups did not differ in terms of the median time to the first feeding or the hospital length of stay.

The team observed that similar percentages of patients in the 2 groups required reoperation, intensive care unit (ICU) admission, and readmission to the hospital because of postoperative complications.

Dr Estay's team concludes, "The frequency of postoperative complications after laparoscopic colorectal surgery was no higher among the obese patients than among the nonobese patients."

Surg Endoscopy 2014: 28(7): 2090-2096
07 July 2014

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