There has been a long-lasting controversy about whether higher BMI is associated with worse perioperative outcomes of laparoscopic colorectal surgery.
Recently, a number of newly published investigations have made it possible to draw a quantitative conclusion.
Dr Yazhou He and colleagues econducted this comprehensive meta-analysis to clarify the exact effect that BMI imposes on perioperative outcome of laparoscopic colorectal surgery.
The team systematically searched MEDLINE, Embase, and Cochrane Library databases to identify all relevant studies.
Comparative studies in English that investigated perioperative outcome of laparoscopic colorectal surgery for patients with different BMIs were included.
|BMI was a risk factor for overall complication rates|
|Diseases of the Colon & Rectum|
Quality of studies was evaluated by using the Newcastle-Ottawa Scale.
The researchers' risk factor of interest was BMI.
Effective sizes were pooled under a random-effects model to evaluate preoperative, intraoperative, and postoperative outcomes.
The research team included a total of 43 studies.
The team found that higher BMI was associated with significantly longer operative time, greater blood loss, and higher incidence of conversion to open surgery.
Moreover, BMI was a risk factor for overall complication rates, especially for ileus, and events of the urinary system.
The researchers identified significant association between higher BMI and risk of surgical site infection, and anastomotic leakage.
Higher BMI might also led to a reduced number of harvest lymph nodes for patients with colorectal cancer.
The heterogeneity test identified no significant cross-study heterogeneity, and the results of cumulative meta-analysis, sensitivity analysis, and the publication bias test verified the reliability of our study.
Dr He's team concludes, "Body mass index is a practical and valuable measurement for the prediction of the perioperative outcome of laparoscopic colorectal surgery."
"Higher BMI is associated with worse perioperative outcome."
"More accurate conclusions, with more precise cutoff values, can be achieved by future well-designed prospective investigations."