Impact of obesity on the cost of major colorectal surgery

Abstract

Excess body fat was associated with higher costs of major colorectal surgery.

Colorectal cancer surgery for obese patients: Financial and clinical outcomes of a Dutch population‐based registry

“…Regarding rectal cancer surgery, an Australian study showed no differences in clinical outcomes (complications and/or mortality) of patients with BMIs <30 and >30 kg/m 2 whereas a NSQIP study from the United States of America (USA) showed a higher risk of overall morbidity for patients with BMIs >35 kg/m 2 . A study from the USA that analyzed colon cancer procedures found no significant differences in clinical outcomes (complications and/or mortality) between none‐obese and obese patients whereas other studies from New Zealand and the USA have found only increased risks of wound‐related complications for obese patients (no significant differences in severe complications or mortality were found) .…”

“…However, (multi‐center) evidence regarding whether obesity has a major impact on hospital costs after colorectal cancer surgery remains scarce. A recent single‐center study from New Zealand showed a significant increase in hospital costs for obese patients (>30 kg/m 2 ); however, likely due to a small sample size (n = 345), no distinctions between obesity classes were noted . Two recent multi‐center studies reported diverse results; a study from the USA reported no differences in hospital costs between non‐obese and obese patients, whereas a Japanese study reported a significant increase in hospital costs for obese patients (>30 kg/m 2 ) .…”

“…Regarding mortality, evidence from general surgery suggest that there seems to be a so‐called “obesity paradox” that involves pre‐obese and mildly obese surgical patients having lower mortality rates than patients of normal weight . However, for colorectal cancer patients, this relationship has not yet been identified .…”

“…A specific population that is at risk includes colorectal cancer patients suffering from obesity. These patients are associated with increased post‐operative risks of pulmonary complications, wound infections, and cardiovascular events . Regarding mortality, evidence from general surgery suggest that there seems to be a so‐called “obesity paradox” that involves pre‐obese and mildly obese surgical patients having lower mortality rates than patients of normal weight .…”

“…Multi‐center studies describing whether obesity has a major impact on hospital costs after colorectal cancer surgery are scarce. Existing studies describing this relationship have been conducted in the relatively obese populations of the United States and New Zealand and the relatively none‐obese population of Japan . It remains unclear, however, whether these results can be generalized to countries with more intermediate BMI distributions such as Sweden, France and the Netherlands .…”