Impact of obesity on the short-term outcomes of single-port laparoscopic colectomy for colorectal cancer in the Asian population: A retrospective cohort study

Single-port laparoscopic surgery (SPLS) is being increasingly performed for treating colorectal cancer. Here, we aimed to assess the safety and feasibility of SPLS for colorectal cancer in obese patients through a comparison of their short-term outcomes with those of nonobese patients. A total of 323 patients who underwent SPLS for colorectal cancer at our center between March 2009 and August 2014 were enrolled. The outcomes were analyzed according to the body mass index (BMI) category: nonobese (BMI < 25), obese I (BMI: 25.0–29.9), and obese II (BMI ≥ 30). Of the 323 patients, 233 (72.1%), 80 (24.8%), and 10 (3.1%), were assigned to the nonobese, obese I, and obese II groups, respectively. The clinicopathologic patient characteristics, such as age, gender, tumor location, and previous laparotomy, were similar among the 3 groups. The mean operative time (nonobese vs obese I vs and obese II groups: 269.2 vs 270.4 vs 342.8 minutes, respectively) and estimated surgical blood loss (277.7 vs 260.5 vs 387.0 mL, respectively) were greater in the obese II group than in the nonobese and obese I groups, although the difference was not significant (P = .247 and P = .205, respectively). However, the time to passage of flatus significantly differed among the groups (P = .040); in particular, this value was significantly longer in the obese II group than in the obese I group (P = .031). None of the other parameters, including conversion to open or conventional laparoscopic surgery and intra- and postoperative morbidity, significantly differed among the 3 groups. SPLS for colorectal cancer can be safely performed in obese Asian patients with equivalent short-term outcomes as compared with that in nonobese patients. Hence, SPLS can be safely recommended for colorectal cancer in obese patients if the surgeon is experienced. Nevertheless, the technique used warrants further investigation, and a large-scale prospective study is required.