Is Laparoscopic Colectomy Applicable to Patients With Body Mass Index >30? A Case-Matched Comparative Study With Open Colectomy

• DOI: 10.1007/s10350-004-0941-0
• Publication Date: 2005-03-24T20:39:47Z
• Authors: Conor P. Delaney; Naveen Pokala; Anthony J. Senagore; Sergio Casillas; Ravi P. Kiran; Karen M. Brady; Victor W. Fazio
• Keywords: Colorectal Surgery

The benefits of early postoperative recovery, reduced pain, pulmonary dysfunction, and hospitalization after laparoscopic colectomy may improve outcome over open in obese patients. This case-matched study compares outcomes colectomy.A total 94 patients with a body mass index >30 (Jan 1999-June 2003) were identified from prospective database matched to cases for age, gender, index, American Society Anesthesiologists class, procedure, indication, date surgery. Operating time, length stay, conversion, intraoperative complications, reoperation, 30-day readmission rate, costs compared. Data are presented as means +/- standard deviations, appropriate statistical tests used.The two groups age (P = 0.06), gender 1), class 0.2), 0.4), indication surgery procedure 1). By using intention-to-treat-type analysis, there was no difference median operating time (100 vs. 110 (mean, 123 112) minutes; P 0.1), complications (21 24 percent; 0.74), (17 10.6 0.3), reoperation rates (6.4 4.3 0.75), or direct (median, US. 3,368 dollars US 3,552 dollars; mean, 4,003 4,037 0.14) between colectomy; however, the stay (3 5.5 3.8 5.8) days; 0.0001) significantly shorter colectomy. Twenty-eight required conversion adhesions (n 11), bleeding 3), obesity-hindering vision dissection 9), large phlegmon tumor 4), ureteric injury mean conversions 142 minutes 6.4 days. Compared laparoscopically completed cases, (5 2 2.8) times (150 95 115) 0.02) higher converted group, but complication 0.8), 0.7) rates. colectomy, group significant differences 0.18), 0.35), reoperative 1) rates.Laparoscopic can be performed safely patients, recovery than that Although obesity is associated high these comparable cases.