The influence of obesity on short- and long-term outcomes after laparoscopic surgery for colon cancer: A case-matched study of 152 patients

Abstract

Despite the increasing prevalence of obesity and colonic diseases, the impact of obesity on short-term and oncologic outcomes of laparoscopic colorectal surgery still remains unclear. Seventy-six consecutive obese patients with body mass index (BMI) ≥30kg/m(2) who underwent laparoscopic colectomy were matched with 76 nonobese patients with BMI <30kg/m(2). Perioperative parameters and oncologic outcomes were analyzed in the two groups. Obesity was associated with greater operative time (obese vs nonobese, 182±59 vs 157±55min, P=.0084) and multivariate analysis identified BMI (hazard ratio 2.11, 95% confidence interval 0.64-3.56, P=.0049) as an independent predicting factor for operative time together with cancer location (hazard ratio 28.6, 95% confidence interval 14.62-42.51, P<.0001). Obesity had no adverse influence on overall morbidity (25 vs 21%, P=.563), however, or postoperative duration of stay (median 6.0 vs 5.5days, P=.22). Furthermore, the rate of conversion to open procedure was similar between the two groups (9 vs 9%, P>.99). Regarding oncologic outcomes, there was no statistical difference in overall and disease-free survival between the two groups (5-year overall survival rate 86 vs 89%, P=.72, 5-year disease survival rate 70 vs 77%, P=.70). Laparoscopic colonic resection, when performed for selected patients, appears to be a safe and reasonable option in obese patients with colon cancer resulting in similar short-term and oncologic outcomes as nonobese patients.