Authors: Gabriela M Vargas Eric P Sieloff Abhishek D Parmar Nina P Tamirisa Hemalkumar B Mehta Taylor S Riall
Publish Date: 2015/08/19
Volume: 30, Issue: 5, Pages: 1826-1832
Abstract
While there are many reported advantages to laparoscopic surgery compared to open surgery the impact of a laparoscopic approach on postoperative morbidity in obese patients undergoing rectal surgery has not been studied Our goal was to determine whether obese patients undergoing laparoscopic rectal surgery experienced the same benefits as nonobese patientsWe identified patients undergoing rectal resections using the National Surgical Quality Improvement Project Participant Use Data File We performed multivariable analyses to determine the independent association between laparoscopy and postoperative complicationsA total of 26437 patients underwent rectal resection The mean age was 585 years 326 were obese and 472 had cancer Laparoscopic procedures were slightly less common in obese patients compared to nonobese patients 360 vs 382 p = 00006 In unadjusted analyses complications were lower with the laparoscopic approach in both obese 189 vs 324 p 00001 and nonobese 156 vs 253 p 00001 patients In a multivariable analysis controlling for potential confounders the risk of postoperative complications increased as the degree of obesity worsened The likelihood of experiencing a postoperative complication increased by 25 45 and 75 for obese class I obese class II and obese class III patients respectively A laparoscopic approach was associated with a 40 decreased odds of a postoperative complication for all patients OR 060 95 CI 056–064Laparoscopic rectal surgery is associated with fewer complications when compared to open rectal surgery in both obese and nonobese patients Obesity was an independent risk factor for postoperative complications In appropriately selected patients rectal surgery outcomes may be improved with a minimally invasive approach
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