Morbid Obesity is Associated with Increased Mortality, Surgical Complications, and Incremental Health Care Utilization in the Peri‐Operative Period of Colorectal Cancer Surgery

Hussan, Hisham; Gray, Darrell M.; Hinton, Alice; Krishna, Somashekar G.; Conwell, Darwin L.; Stanich, Peter P.

doi:10.1007/s00268-015-3358-0

Cited by 57 publications

(49 citation statements)

References 37 publications

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“…Anastomotic leak of a gastrointestinal and/or pancreatic/biliary anastomosis was examined in 63 (53.4%) studies (Table ) . Among the studies that specifically considered this outcome, only 13 (20.6%) noted a higher incidence of anastomotic leak among obese patients . In studies that examined only patients with enteric anastomoses ( n = 52), the incidence of anastomotic leak was noted to be no higher among obese patients in 10 (19.2%) studies .…”

Section: Resultsmentioning

confidence: 98%

“…Overall operative time was included in the majority of studies and was the only reported outcome that was associated with obesity in a majority of publications (Table ) . Among the 70 studies that included operative time as an outcome metric, 42 (60%) reported that obesity was associated with a longer operative time …”

Section: Resultsmentioning

confidence: 99%

“…Sub‐group analysis by disease site for colorectal and gastric cancer had similar results, with the majority of studies within each of these groups indicating that obese patients did not have a higher risk of surgical morbidity. Mortality, though uncommon in the immediate post‐operative period, was included as a reported metric in 57 studies and only a small minority (3/57, 5.3%) suggested an association of obesity with increased mortality (Table ) …”

Section: Resultsmentioning

confidence: 99%

“…Among the studies that specifically considered this outcome, only 13 (20.6%) noted a higher incidence of anastomotic leak among obese patients . In studies that examined only patients with enteric anastomoses ( n = 52), the incidence of anastomotic leak was noted to be no higher among obese patients in 10 (19.2%) studies . Among the 63 studies that examined length‐of‐stay, only 11 (17.5%) identified obesity as a risk factor for increased length‐of‐stay (Table ) …”

Section: Resultsmentioning

confidence: 99%

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Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review

Hughes

Shah

Noria

et al. 2018

Journal of Surgical Oncology

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We systematically reviewed 118 studies comparing peri-operative outcomes among obese and non-obese patients. Obesity was associated with longer operative time in 60% of available studies. Just 35.8% of studies that evaluated overall morbidity identified high morbidity in obese patients. Lymph node yield or surgical margin status, was only affected by obesity in 19.6% of studies. In this review obesity was frequently found to have no effect on peri-operative and oncologic outcomes.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review

Hughes

Shah

Noria

et al. 2018

Journal of Surgical Oncology

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“…Epidemiologic data strongly support the observation that people with metabolic syndrome are at increased risk of colorectal adenoma and cancer 15, 16. Mortality due to colon cancer and obesity is greatly influenced by both genetic and environmental etiologic factors 17. Adipokines may play a crucial role in linking these two diseases 18, 19.…”

Section: Introductionmentioning

confidence: 81%

ADIPOQ rs266729 G/C gene polymorphism and plasmatic adipocytokines connect metabolic syndrome to colorectal cancer

Divella

Daniele

Mazzocca³

et al. 2017

J. Cancer

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Background: ADIPOQ gene, which encode for Adiponectin (APN), is sited on chromosome 3q27 and linked to a susceptibility locus for metabolic syndrome (MetS). The ADIPOQ rs266729 G/C gene polymorphism is significantly associated with low APN levels and linked to susceptibility to develop cancer. In addition, decreased APN serum levels are linked with tumor development and progression and inversely associated with markers of inflammation. Here, we investigate the influence of APN rs266729 G/C polymorphism on adipocytokine circulating levels and their association with MetS in colorectal cancer patients (CRC).Methods: Blood samples from 105 CRC patients (50 women and 55 men) with and without MetS were genotyped for APN rs266729 G/C polymorphism by TETRA ARMS PCR. ELISA assay was used to measure plasma levels of APN and inflammatory TNF-α cytokine. Biochemical and anthropometric parameters of MetS were also analyzed.Results: We found that CRC patients (N=75) with genotype rs266729G/C or carriers of G allele were associated with a significantly increased risk of MetS development (OR =2.9) compared to those with CC genotype (N=30). Also, CG/GG genotypes were associated with significantly lower plasma APN levels and higher TNF-α levels in comparison to CC genotype (P=0.034) and APN levels were decreased in relation to BMI increases (P=0.001).Conclusions: Our findings show that APN rs266729 G/C polymorphism is associated with lower APN levels in CRC patients, indicating that decreased circulating levels of APN may be a determinant risk factor for CRC in MetS patients.

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Obesity as a surgical risk factor

Aikou

Seto

2017

Annals of Gastroent Surgery

155

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In recent years, both the actual number of overweight/obese individuals and their proportion of the population have steadily been rising worldwide and obesity‐related diseases have become major health concerns. In addition, as obesity is associated with an increased incidence of gastroenterological cancer, the number of obese patients has also been increasing in the field of gastroenterological surgery. While the influence of obesity on gastroenterological surgery has been widely studied, very few reports have focused on individual organs or surgical procedures, using a cross‐sectional study design. In the present review, we aimed to summarize the impacts of obesity on surgeries for the esophagus, stomach, colorectum, liver and pancreas. In general, obesity prolongs operative time. As to short‐term postoperative outcomes, obesity might be a risk for certain complications, depending on the procedure carried out. In contrast, it is possible that obesity doesn't adversely impact long‐term surgical outcomes. The influences of obesity on surgery are made even more complex by various categories of operative outcomes, surgical procedures, and differences in obesity among races. Therefore, it is important to appropriately evaluate perioperative risk factors, including obesity.

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Morbid Obesity is Associated with Increased Mortality, Surgical Complications, and Incremental Health Care Utilization in the Peri‐Operative Period of Colorectal Cancer Surgery

Cited by 57 publications

References 37 publications

Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review

Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review

ADIPOQ rs266729 G/C gene polymorphism and plasmatic adipocytokines connect metabolic syndrome to colorectal cancer

Obesity as a surgical risk factor

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