Cargando…

Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery

BACKGROUND: Obesity is a state in which excess heat is converted into excess fat, which accumulates in the body and may cause damage to multiple organs of the circulatory, endocrine, and digestive systems. Studies have shown that the accumulation of abdominal fat and mesenteric fat hypertrophy in pa...

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Ying, Deng, Ji-Jun, Jiang, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198097/
https://www.ncbi.nlm.nih.gov/pubmed/37214581
http://dx.doi.org/10.12998/wjcc.v11.i12.2766
_version_ 1785044677322342400
author Li, Ying
Deng, Ji-Jun
Jiang, Jun
author_facet Li, Ying
Deng, Ji-Jun
Jiang, Jun
author_sort Li, Ying
collection PubMed
description BACKGROUND: Obesity is a state in which excess heat is converted into excess fat, which accumulates in the body and may cause damage to multiple organs of the circulatory, endocrine, and digestive systems. Studies have shown that the accumulation of abdominal fat and mesenteric fat hypertrophy in patients with obesity makes laparoscopic surgery highly difficult, which is not conducive to operation and affects patient prognosis. However, there is still controversy regarding these conclusions. AIM: To explore the relationship between body mass index (BMI) and short-term prognosis after surgery for colorectal cancer. METHODS: PubMed, Embase, Ovid, Web of Science, CNKI, and China Biology Medicine Disc databases were searched to obtain relevant articles on this topic. After the articles were screened according to the inclusion and exclusion criteria and the risk of literature bias was assessed using the Newcastle-Ottawa Scale, the prognostic indicators were combined and analyzed. RESULTS: A total of 16 articles were included for quantitative analysis, and 15588 patients undergoing colorectal cancer surgery were included in the study, including 3775 patients with obesity and 11813 patients without obesity. Among them, 12 articles used BMI ≥ 30 kg/m(2) and 4 articles used BMI ≥ 25 kg/m(2) for the definition of obesity. Four patients underwent robotic colorectal surgery, whereas 12 underwent conventional laparoscopic colorectal resection. The quality of the literature was good. Meta-combined analysis showed that the overall complication rate of patients with obesity after surgery was higher than that of patients without obesity [OR = 1.35, 95%CI: 1.23-1.48, Z = 6.25, P < 0.0001]. The incidence of anastomotic leak after surgery in patients with obesity was not significantly different from that in patients without obesity [OR = 0.99, 95%CI: 0.70-1.41), Z = -0.06, P = 0.956]. The incidence of surgical site infection (SSI) after surgery in patients with obesity was higher than that in patients without obesity [OR = 1.43, 95%CI: 1.16-1.78, Z = 3.31, P < 0.001]. The incidence of reoperation in patients with obesity after surgery was higher than that in patients without obesity; however, the difference was not statistically significant [OR = 1.15, 95%CI: 0.92-1.45, Z = 1.23, P = 0.23]; Patients with obesity had lower mortality after surgery than patients without obesity; however, the difference was not statistically significant [OR = 0.61, 95%CI: 0.35-1.06, Z = -1.75, P = 0.08]. Subgroup analysis revealed that the geographical location of the institute was one of the sources of heterogeneity. Robot-assisted surgery was not significantly different from traditional laparoscopic resection in terms of the incidence of complications. CONCLUSION: Obesity increases the overall complication and SSI rates of patients undergoing colorectal cancer surgery but has no influence on the incidence of anastomotic leak, reoperation rate, and short-term mortality rate.
format Online
Article
Text
id pubmed-10198097
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-101980972023-05-20 Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery Li, Ying Deng, Ji-Jun Jiang, Jun World J Clin Cases Meta-Analysis BACKGROUND: Obesity is a state in which excess heat is converted into excess fat, which accumulates in the body and may cause damage to multiple organs of the circulatory, endocrine, and digestive systems. Studies have shown that the accumulation of abdominal fat and mesenteric fat hypertrophy in patients with obesity makes laparoscopic surgery highly difficult, which is not conducive to operation and affects patient prognosis. However, there is still controversy regarding these conclusions. AIM: To explore the relationship between body mass index (BMI) and short-term prognosis after surgery for colorectal cancer. METHODS: PubMed, Embase, Ovid, Web of Science, CNKI, and China Biology Medicine Disc databases were searched to obtain relevant articles on this topic. After the articles were screened according to the inclusion and exclusion criteria and the risk of literature bias was assessed using the Newcastle-Ottawa Scale, the prognostic indicators were combined and analyzed. RESULTS: A total of 16 articles were included for quantitative analysis, and 15588 patients undergoing colorectal cancer surgery were included in the study, including 3775 patients with obesity and 11813 patients without obesity. Among them, 12 articles used BMI ≥ 30 kg/m(2) and 4 articles used BMI ≥ 25 kg/m(2) for the definition of obesity. Four patients underwent robotic colorectal surgery, whereas 12 underwent conventional laparoscopic colorectal resection. The quality of the literature was good. Meta-combined analysis showed that the overall complication rate of patients with obesity after surgery was higher than that of patients without obesity [OR = 1.35, 95%CI: 1.23-1.48, Z = 6.25, P < 0.0001]. The incidence of anastomotic leak after surgery in patients with obesity was not significantly different from that in patients without obesity [OR = 0.99, 95%CI: 0.70-1.41), Z = -0.06, P = 0.956]. The incidence of surgical site infection (SSI) after surgery in patients with obesity was higher than that in patients without obesity [OR = 1.43, 95%CI: 1.16-1.78, Z = 3.31, P < 0.001]. The incidence of reoperation in patients with obesity after surgery was higher than that in patients without obesity; however, the difference was not statistically significant [OR = 1.15, 95%CI: 0.92-1.45, Z = 1.23, P = 0.23]; Patients with obesity had lower mortality after surgery than patients without obesity; however, the difference was not statistically significant [OR = 0.61, 95%CI: 0.35-1.06, Z = -1.75, P = 0.08]. Subgroup analysis revealed that the geographical location of the institute was one of the sources of heterogeneity. Robot-assisted surgery was not significantly different from traditional laparoscopic resection in terms of the incidence of complications. CONCLUSION: Obesity increases the overall complication and SSI rates of patients undergoing colorectal cancer surgery but has no influence on the incidence of anastomotic leak, reoperation rate, and short-term mortality rate. Baishideng Publishing Group Inc 2023-04-26 2023-04-26 /pmc/articles/PMC10198097/ /pubmed/37214581 http://dx.doi.org/10.12998/wjcc.v11.i12.2766 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Meta-Analysis
Li, Ying
Deng, Ji-Jun
Jiang, Jun
Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
title Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
title_full Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
title_fullStr Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
title_full_unstemmed Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
title_short Relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
title_sort relationship between body mass index and short-term postoperative prognosis in patients undergoing colorectal cancer surgery
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198097/
https://www.ncbi.nlm.nih.gov/pubmed/37214581
http://dx.doi.org/10.12998/wjcc.v11.i12.2766
work_keys_str_mv AT liying relationshipbetweenbodymassindexandshorttermpostoperativeprognosisinpatientsundergoingcolorectalcancersurgery
AT dengjijun relationshipbetweenbodymassindexandshorttermpostoperativeprognosisinpatientsundergoingcolorectalcancersurgery
AT jiangjun relationshipbetweenbodymassindexandshorttermpostoperativeprognosisinpatientsundergoingcolorectalcancersurgery