Obesity as a determinant of perioperative and postoperative outcome in patients following colorectal cancer surgery: A population-based study (2009–2016). Issue 12 (December 2018)

• Record Type: Journal Article
• Authors: Poelemeijer, Youri Q.M.; Lijftogt, Niki; Detering, Robin; Fiocco, Marta; Tollenaar, Rob A.E.M.; Wouters, Michel W.J.M.
• Is Part Of: European journal of surgical oncology. Volume 44:Issue 12(2018)
• Page Start: 1849
• Page End: 1857
• Publication Date: 2018-12
• Subjects: Obesity -- Dutch ColoRectal audit -- Colorectal cancer -- Outcome -- Population-based -- Complications; ASA American Society of Anesthesiologists -- CCI Charlson Comorbidity Index -- CD Clavien–Dindo Classification of Surgical Complications -- CRC colorectal cancer -- DCRA Dutch ColoRectal Audit -- ERAS enhance recovery after surgery -- NCC patient normal-weight colon cancer patient -- NRC patient normal-weight rectal cancer patient -- OCC patient obese colon cancer patient -- ORC patient obese rectal cancer patient; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2018.05.027
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Background: Obesity is an increasing problem worldwide that can influence perioperative and postoperative outcomes. However, the relationship between obesity and treatment-related perioperative and short-term postoperative morbidity after colorectal resections is still subject to debate. Study: Patients were selected from the DCRA, a population-based audit including 83 hospitals performing colorectal cancer (CRC) surgery. Data regarding primary resections between 2009 and 2016 were eligible for analyses. Patients were subdivided into six categories: underweight, normal weight, overweight and obesity class I, II and III. Results: Of 71, 084 patients, 17.7% with colon and 16.4% with rectal cancer were categorized as obese. Significant differences were found for the 30-day overall postoperative complication rate (p < 0.001), prolonged hospitalization (p < 0.001) and readmission rate (colon cancer p < 0.005; rectal cancer p < 0.002) in obese CRC patients. Multivariate analysis identified BMI ≥30 kg/m 2 as independent predictor of a complicated postoperative course in CRC patients. Furthermore, obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate. No significant differences in performance were observed in postoperative outcomes of morbidly obese CRC patients between hospitals performing bariatric surgery and hospitals that did not. Conclusion: The real-life data analysed in this study reflect daily practice in the Netherlands and identify obesity as a significant risk factor in CRC patients. Obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate in obese CRC patients. No differences were observed between hospitals performing bariatric surgery and hospitals that did not.