Is laparoscopic colorectal cancer surgery associated with an increased risk in obese patients? A retrospective study from China

BACKGROUND: The impact of obesity on surgical outcomes after laparoscopic colorectal cancer resection in Chinese patients is still unclear. METHODS: We 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/m(2)), obese I (BMI 25.0 = to 29.9 kg/m(2)) and obese II (BMI ≥30.0 kg/m(2)). Clinical characteristics, surgical outcomes and postoperative complications were compared between nonobese, obese I and obese II patients. RESULTS: From 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. CONCLUSION: With sufficient experience, laparoscopic colorectal cancer surgery is feasible and safe in obese Chinese patients.