The influence and countermeasure of obesity in laparoscopic colorectal resection

摘要

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/msup2/sup (n?=?113) and those with a BMI 25?kg/msup2/sup (n?=?279). The influence of BMI on LCR was investigated. Study 2: Patients with a BMI ≥28?kg/msup2/sup who were scheduled to undergo LCR (n?=?7, mean body weight 87.0?kg, mean BMI 33.9?kg/msup2/sup) 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/msup2/sup group had a prolongation of operation time and hospital stay than the BMI 25?kg/msup2/sup 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/msup2/sup group. Conclusion Obesity affected the surgical outcomes in LCR. A PWLP may be useful for obese patients undergoing LCR.