Laparoscopic colorectal cancer surgery in obese patients

Singh, Amanjeet; Muthukumarasamy, Girivasan; Pawa, Nikhil; Riaz, Amjid; Hendricks, Jane; Motson, R. W.

doi:10.1111/j.1463-1318.2010.02348.x

Cited by 63 publications

(98 citation statements)

References 22 publications

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“…Zou et al [25] reported that obesity was associated with increased wound infection, ileus, incisional hernia, and with pulmonary events. The incidence of wound infection seen in obese patients in our study, which was similar to that in other studies [26,27], was significantly higher than that in non-obese patients (8.3% vs 1.9%).…”

Section: Discussionsupporting

confidence: 77%

“…However, these results were based on the short-term outcomes of laparoscopic colorectal surgery. Several investigators have studied the long-term prognostic outcomes after laparoscopic colorectal cancer surgery in obese patients [26] [34]. No statistically significant differences were observed between the obese and non-obese patients in terms of the disease-free survival and overall survival.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

et al. 2014

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

et al. 2014

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“…19,21 However, several studies have shown that there were no significant differences in survival between obese and non-obese Western patients. 5,22 To our knowledge, few studies have examined long-term surgical outcomes following laparoscopic colorectal cancer in Asian patients. The results of this study showed no significant differences in disease-free and overall survival between obese and non-obese patients in Asian countries.…”

Section: Discussionmentioning

confidence: 99%

Long-term Oncologic Outcomes of Obesity after Laparoscopic Surgery for Colorectal Cancer in Asian Patients

Kwak

Park

et al. 2016

J Minim Invasive Surg

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Purpose:The adverse effects of obesity on short-term surgical outcomes after laparoscopic colorectal surgery have been reported. However, the influence of obesity on long-term oncological outcomes after laparoscopic surgery in Asian patients has not been well understood. The aim of this study was to evaluate the effect of obesity on long-term oncologic outcomes in patients who underwent laparoscopic surgery for colorectal cancer. Results:Of the 424 patients, 325 (76.7%) were classified as non-obese and 99 (23.3%) as obese. The clinicopathologic characteristics of the obese and non-obese groups were similar, except that there were more underlying comorbidities, a lower frequency of smoking, and fewer tumors in rectum in the obese group. Results of the multivariate analysis showed that older age, elevated serum carcinoembryonic antigen, high-grade histology, advanced tumor stage, and perineural invasion were associated with poorer disease-free survival and overall survival. Obesity was not significantly associated with disease-free survival (hazard ratio [HR] Conclusion:Laparoscopic surgery for colorectal cancer seems to be safe and feasible for obese patients in terms of long-term oncologic outcomes.

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“…56 Short-term morbidity for rectal cancer resection seems to be increased with obesity. In addition, obesity is reported to be significantly associated with rates of anastomotic leak, 57,58 parastomal hernia, 59 wound infection, 60,61 length of laparoscopic surgery according to BMI, [46][47][48]60 length of laparoscopic surgery according to visceral adipose area, 62,63 overall and systemic complications, 62 more frequent conversion to laparotomy, 46,64 more blood loss, 47,58,63 and longer hospital stay. 48 In addition, obese patients undergoing laparoscopic colorectal surgery are at an increased risk for conversion to open operation and operative times are significantly increased for obese patients having rectal cancer surgery.…”

Section: Obesity and Colorectal Surgery Outcomesmentioning

confidence: 99%

Obesity and Colorectal Cancer

Myung

2012

Korean J Gastroenterol

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Obesity is a risk factor for colorectal cancer based on its molecular and metabolic effects on insulin and IGF-1, leptin, adipocytokines, and sex hormones. Obese men have a higher risk of colorectal cancer compared with normal weight men, but the association between obesity and rectal cancer is weaker than with colon cancer. There is a weaker association between obesity and colon cancer in women than in men, and no appreciable association between obesity and rectal cancer in women. Although obesity does not seem to have an effect on the number of lymph nodes harvested with resection, obesity does seem to be associated with more-aggressive colorectal cancers in a handful of studies. Survival and local recurrence studies are contradictory with no conclusive evidence that obesity predisposes to worse overall survival or increased recurrence in colon and rectal cancers. The literature is not definitive as far as overall morbidity and mortality rates in the obese are concerned, though obese rectal cancer patients seem to incur proportionally more morbidity and mortality. Preexisting steatosis or steatohepatitis in obese colorectal cancer patients or chemotherapy-induced liver dysfunction may lead to an increased mortality in obese patients with colorectal liver metastases. Diabetes may cause poorer response to neoadjuvant therapy in rectal cancer and contribute to higher mortality and recurrence in colon cancer.KEYWORDS: Obesity, colon cancer, rectal cancer, diabetes, men, women Objectives: After reading this review, the reader should be able to summarize how and why obesity is a risk factor for colorectal cancer, and have an appreciation for how definitions of obesity vary and impact study results. In addition, the reader should also understand the impact of obesity on colorectal cancer short-term outcomes, long-term oncologic outcomes, and how obesity can impact the chemotherapeutic treatment of metastatic disease.Colorectal cancer (CRC) is a major cause of cancer death in Western societies and it is well known that this elevated risk is related to an imbalance between neoplasia promoting and protective dietary and lifestyle factors. Among the factors that tend to elevate risk are a high intake of animal fat, high calorie intake, high intake of processed foods with low fiber content, limited physical activity, excess alcohol intake, and finally obesity.What follows is a discussion on how and why obesity is a risk factor for colorectal cancer and how obesity influences short-and long-term oncologic outcomes from a surgical, pathologic, radiotherapy, and chemotherapeutic perspective. The data leads one to conclude that obesity has implications in all aspects of the care of colorectal cancer patients, from screening to surgical treatment to adjuvant or neoadjuvant treatments.

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Laparoscopic colorectal cancer surgery in obese patients

Cited by 63 publications

References 22 publications

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

The Impact of Body Mass Index on Perioperative Outcomes After Laparoscopic Colorectal Surgery

Long-term Oncologic Outcomes of Obesity after Laparoscopic Surgery for Colorectal Cancer in Asian Patients

Obesity and Colorectal Cancer

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