Obesity Increases Wound Complications in Rectal Cancer Surgery

Balentine, Courtney J.; Wilks, Jonathan A.; Robinson, Christina M.; Marshall, C.; Anaya, Daniel A.; Albo, Daniel; Berger, David H.

doi:10.1016/j.jss.2010.03.012

Cited by 68 publications

(42 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Significant independent risk factors have been previously identified, both in plastic surgery and in other specialities (40,44,45,50,72,(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93). However, the advantage of the present study is the evaluation of four different reconstruction methods with the same criteria for complications.…”

Section: Discussionmentioning

confidence: 92%

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

et al. 2017

View full text Add to dashboard Cite

being, health-related quality of life and satisfaction (5,7-10).Patients' satisfaction and health-related quality of life are frequently used as parameters for outcome measurement in plastic surgery. Postoperative complications after breast reconstruction are common and affect patient satisfaction.Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. 2.05, 95% confidence interval (CI) 1.25-3.37, P=0.0005], followed by body mass index (BMI) (OR 1.07, 95% CI 1.01-1.13, P=0.017). High BMI was associated with the highest number of late overall postoperative complications (OR 1.06, 95% CI 1.00-1.11, P=0.042), followed by history of radiotherapy (OR 1.66, 95% CI 1.01-2.74, P=0.046). When the risk factors were combined, the risk for postoperative complications rose exponentially.Conclusions: Our results provide evidence that patients should cease smoking and overweight patients should lose weight before undergoing breast reconstruction. Additionally, if the patient has received radiotherapy, the reconstruction method should be carefully chosen. High BMI, history of radiotherapy, and smoking are independent risk factors for many types of both early and late postoperative complications in breast reconstructive surgery. Combining these risk factors multiplies the risk of postoperative complications.

show abstract

Section: Discussionmentioning

confidence: 92%

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Several adult studies have provided conflicting data regarding the incidence of postoperative surgical site infection in obese patients with malignancy [12,15,17,34,35]. In a review of 150 patients undergoing surgery for rectal cancer, Balentine et al [35] identified an elevated BMI to be significantly associated with increased wound complications in both minimally invasive and open surgical resection, a trend they speculated may be attributed to prolonged operative time in obese patients [17]. Similarly, an analysis of the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) dataset demonstrated that severely morbidly obese patients had a higher rate of surgical site infection and wound dehiscence compared to normal weight patients [12].…”

Section: Discussionmentioning

confidence: 99%

“…While long-term obesity-related health concerns such as type 2 diabetes mellitus and cardiovascular disease are wellestablished [3][4][5], recent literature has highlighted the increased risk for the occurrence of certain malignancies, including those arising from the gastrointestinal tract, kidney, breast, and endometrium, among obese adults [6][7][8][9][10]. In addition to increasing reports highlighting the apparent link(s) between chronic obesity and the development of cancer, numerous investigations have reported an increased incidence of documented treatment-related morbidity following the associated surgical and medical management of malignancies among obese adults when compared to individuals with a lean body habitus [11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Obesity is a Risk Factor for Renal Toxicity and Wound Complications among a Cohort of Pediatric Cancer Patients at a Single Tertiary Care Institution

Aldrink

Paris²,

Wang³

et al. 2014

J Obes Weight Loss Ther

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

Obesity Increases Wound Complications in Rectal Cancer Surgery

Cited by 68 publications

References 20 publications

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

Obesity is a Risk Factor for Renal Toxicity and Wound Complications among a Cohort of Pediatric Cancer Patients at a Single Tertiary Care Institution

Obesity and Colorectal Cancer

Contact Info

Product

Resources

About