Laparoscopic vs. Open Surgery for Stage II/III Colon Cancer Patients With Body Mass Index >25 kg/m²

Abstract

Aim: To compare long-and short-term outcomes of laparoscopic surgery with those of open surgery for patients with colorectal cancer and body mass index over 25 kg/m 2. Patients and Methods: This multicentre, retrospective study analysed clinical records and identified 178 patients with body mass index over 25 kg/m 2 who underwent surgery for colon and rectosigmoid cancer between 2000 and 2016. After applying propensity score matching, 96 patients were finally included. The primary outcome was the 3-year recurrence-free survival rate, and the secondary outcomes were short-term results during and after surgery. Results: The 3-year recurrence-free survival rates were similar for the laparoscopic and open surgery groups. The laparoscopic surgery group had longer operative times but less blood loss and shorter periods of hospital stay. There were no differences in incidence of postoperative complications. Conclusion: Laparoscopic and open surgeries had similar longterm outcomes for obese patients. Laparoscopic surgery is an effective option for this population.

Video-Laparoscopic versus Open Surgery in Obese Patients with Colorectal Cancer: A Propensity Score Matching Study

“…Moreover, an interrelationship has been demonstrated between obesity and increased postoperative adverse events, such as readmission, reintervention, and mortality [ 12 , 14 , 15 ]. These events are partially due to the higher occurrence of cardiopulmonary comorbidities and wound healing disorders in obese subjects [ 16 , 17 , 18 ].…”

Impact of obesity on short‐term outcomes of laparoscopic colorectal surgery for Japanese patients with colorectal cancer: A multicenter study

“…With regard to Asian patients, previous reports also revealed preferable outcomes for LAC, even for patients with BMI ≥25 kg/m 2 who have more comorbidities 9,10,13 . Furthermore, these studies have also reported relatively lower conversion rates (3.1% to 4.0%) than previously reported (14% to 45%) 9,10 . One possible explanation for this discrepancy is that the lower conversion rates were reported by specialized high‐volume centers.…”

“…However, recent retrospective studies have revealed that LAC performed in obese patients is acceptable in terms of operation time, estimated blood loss, postoperative complications, and recovery time 28,29,30 . With regard to Asian patients, previous reports also revealed preferable outcomes for LAC, even for patients with BMI ≥25 kg/m 2 who have more comorbidities 9,10,13 . Furthermore, these studies have also reported relatively lower conversion rates (3.1% to 4.0%) than previously reported (14% to 45%) 9,10 .…”

“…Furthermore, the rate of infectious complications was lower in LAC. In obese patients, LAC can be technically difficult in terms of maintaining adequate surgical views in the presence of bulky fat tissue 9 . No RCT has examined the short‐term outcomes of LAC in obese patients.…”

“…No RCT has examined the short‐term outcomes of LAC in obese patients. Several recent retrospective studies have reported that LAC is safe and feasible for obese patients; however, these studies were each conducted in a single specialty center 9‐11 …”