The influence and countermeasure of obesity in laparoscopic colorectal resection

BACKGROUND: The aim of this study was to investigate the influence of obesity and the usefulness of a preoperative weight loss program (PWLP) for obese patients undergoing laparoscopic colorectal resection (LCR). METHODS: Study 1: 392 patients who underwent LCR for colorectal cancer were divided into two groups: those with a body mass index (BMI) ≥25 kg/m(2) (n = 113) and those with a BMI <25 kg/m(2) (n = 279). The influence of BMI on LCR was investigated. Study 2: Patients with a BMI ≥28 kg/m(2) who were scheduled to undergo LCR (n = 7, mean body weight 87.0 kg, mean BMI 33.9 kg/m(2)) undertook a PWLP including caloric restriction and exercise for 29.6 (15–70) days. The effects of this program were evaluated. RESULTS: Study 1: The BMI ≥25 kg/m(2) group had a prolongation of operation time and hospital stay than the BMI <25 kg/m(2) group. Study 2: The patients achieved a mean weight loss of 6.9% (−6.0 kg). The mean visceral fat area was significantly decreased by 18.0%, whereas the skeletal muscle mass was unaffected. The PWLP group had a significantly lower prevalence of postoperative complications compared with the BMI ≥25 kg/m(2) group. CONCLUSION: Obesity affected the surgical outcomes in LCR. A PWLP may be useful for obese patients undergoing LCR.