Is laparoscopic colorectal cancer surgery associated with an increased risk in obese patients? A retrospective study from China.
Is laparoscopic colorectal cancer surgery associated with an increased risk in obese patients? A retrospective study from China.
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腹腔镜结直肠癌手术是否会增加肥胖患者的风险？
DOI：
10.1186/1477-7819-12-184
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发表时间：
2014-06-11
影响因子：
3.2
通讯作者：
Qiu Z
中科院分区：
文献类型：
--
作者：
Xia X;Huang C;Jiang T;Cen G;Cao J;Huang K;Qiu Z
背景：肥胖对中国患者腹腔镜结直肠癌切除术后手术结果的影响尚不清楚。方法回顾性分析2008年1月至2013年9月527例连续行腹腔镜手术的结直肠癌患者的前瞻性资料。将患者分为非肥胖组（BMI <25.0 kg/m2）、肥胖I组（BMI 25.0 ~ 29.9 kg/m2）和肥胖II组（BMI≥30.0 kg/m2）。比较非肥胖、肥胖I型和肥胖II型患者的临床特征、手术结果和术后并发症。结果527例患者中，非肥胖组371例，肥胖I组142例，肥胖II组14例。除了BMI （P= 0.001）外，患者在年龄、性别和美国麻醉师学会级别上匹配良好。中位手术时间与体重增加高度相关（中位：非肥胖= 135分钟，肥胖I = 145分钟，肥胖II = 162.5分钟，P= 0.001）。肥胖II组有轻微的III级并发症倾向（根据Clavien-Dindo手术并发症分级），但差异不显著（非肥胖= 5.1%，肥胖I = 3.5%，肥胖II = 14.3%；P= 0.178）。II级肥胖组发生的III级并发症中没有一例是需要缝合的伤口裂开。其他估计出血量、淋巴结清扫量、手术类型、病理结果、转换率、术后总并发症等方面差异均无统计学意义。结论有了足够的经验，腹腔镜结直肠癌手术在中国肥胖患者中是可行和安全的。
BackgroundThe impact of obesity on surgical outcomes after laparoscopic colorectal cancer resection in Chinese patients is still unclear.MethodsWe retrospectively reviewed the prospectively collected data from 527 consecutive colorectal cancer patients who under went laparoscopic resection from January 2008 to September 2013. Patients were categorized into three groups: nonobese (body mass index (BMI) <25.0 kg/m2), obese I (BMI 25.0 = to 29.9 kg/m2) and obese II (BMI ≥30.0 kg/m2). Clinical characteristics, surgical outcomes and postoperative complications were compared between nonobese, obese I and obese II patients.ResultsFrom among the 527 patients, there were 371 patients with in the nonobese group, 142 patients in the obese I group and 14 patients in the obese II group. The patients were well-matched for age, sex and American Society of Anesthesiologists class, except for BMI (P= 0.001). The median operative time correlated highly significantly with increasing weight (median: nonobese = 135 minutes, obese I = 145 minutes, obese II = 162.5 minutes;P= 0.001). There appeared to be a slight tendency toward grade III complications (rated according to the Clavien-Dindo Classification of Surgical Complications) in the obese II group, but this difference was not significant (nonobese = 5.1%, obese I = 3.5% and obese II = 14.3%;P= 0.178). None of the grade III complications which occurred in the obese II group were wound dehiscences that required a stitch. Other aspects, such as estimated blood loss, harvested lymph nodes, operation type, pathological results, conversion rate and overall postoperative complications, were not statistically significant.ConclusionWith sufficient experience, laparoscopic colorectal cancer surgery is feasible and safe in obese Chinese patients.
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影响因子：
3.2
作者：
Poulsen, Martin;Ovesen, Henrik
通讯作者：
Ovesen, Henrik
影响因子：
3.4
作者：
Singh, A.;Muthukumarasamy, G.;Motson, R. W.
通讯作者：
Motson, R. W.
DOI：
10.1007/s00464-008-0266-5
发表时间：
2009-07-01
影响因子：
3.1
作者：
Bege, Thierry;Lelong, Bernard;Delpero, Jean-Robert
通讯作者：
Delpero, Jean-Robert
影响因子：
3.9
作者：
Delaney, CP;Pokala, N;Fazio, VW
通讯作者：
Fazio, VW
影响因子：
9.6
作者：
Ishii, Y;Hasegawa, H;Kitajima, M
通讯作者：
Kitajima, M