肥胖：结直肠癌腹腔镜手术术后并发症的一个风险因素。
Obesity: A risk factor for postoperative complications in laparoscopic surgery for colorectal cancer.
作者信息
Ramadan Bilal, Dahboul Houssam, Mouawad Christian, Aoun Rany, Kassar Serge, Kassouf Elia, Chakhtoura Ghassan, Noun Roger, Osseis Michael
机构信息
Department of Digestive Surgery, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Department of Digestive Surgery, Hotel Dieu De France Hospital, Saint Joseph University, Beirut, Lebanon.
出版信息
J Minim Access Surg. 2024 Jan 1;20(1):12-18. doi: 10.4103/jmas.jmas_165_22. Epub 2022 Sep 12.
BACKGROUND
The prevalence of obesity in the Eastern Mediterranean is increasing significantly up to 20.8% in 2016. Therefore, a higher percentage of colorectal cancer (CRC) patients are expected to be obese. Laparoscopic colorectal cancer surgery (LCRCS) is regarded as a safe and feasible procedure as laparoscopic approach is becoming the gold standard in CRC surgery, especially in the early stages of disease. However, LCRCS is correlated with a higher risk of short-term post-operative complications in obese patients (body mass index [BMI] ≥30 Kg/m 2 ) than in patients with BMI <30 Kg/m 2 . This study aims to evaluate the impact of obesity on short-term post-operative complications in patients undergoing LCRCS.
MATERIALS AND METHODS
A retrospective study was conducted. Clinical data of case and control patients were extracted from medical records. These patients underwent LCRCS between January 2018 and June 2021 at Hôtel-Dieu de France Hospital, Beirut-Lebanon. Patients were divided into two groups: obese and non-obese. BMI ≥30 Kg/m 2 was used to define obese patients. Post-operative complications in the 30 days following surgery were the primary outcome. The severity of post-operative complications was evaluated using the Clavien-Dindo score. Chi-square test was used to evaluate the statistical correlation between collected variables.
RESULTS
We identified 107 patients who underwent LCRCS during this study period at our institution. Among the patients, 23 were obese (21.49%). At 30 days post-operative, 26 patients were reported to having at least one complication. Non-significant differences were found between the two groups regarding the early post-operative complications rate (obese 26.1% and non-obese 23.8% with P = 0.821). Obesity was not demonstrated as a stratification risk by severity of the early post-operative complications ( P = 0.92).
CONCLUSION
Obesity, which was defined as BMI ≥30 Kg/m 2 , was not a risk factor for early post-operative complications as well as a stratification risk by severity of post-operative complications in LCRCS.
背景
东地中海地区的肥胖患病率显著上升，到2016年达到20.8%。因此，预计结直肠癌（CRC）患者中肥胖者的比例会更高。腹腔镜结直肠癌手术（LCRCS）被认为是一种安全可行的手术方式，因为腹腔镜手术方法正成为CRC手术的金标准，尤其是在疾病的早期阶段。然而，与体重指数（BMI）<30 Kg/m²的患者相比，肥胖患者（BMI≥30 Kg/m²）进行LCRCS术后短期并发症的风险更高。本研究旨在评估肥胖对接受LCRCS患者术后短期并发症的影响。
材料与方法
进行了一项回顾性研究。从病历中提取病例组和对照组患者的临床数据。这些患者于2018年1月至2021年6月在黎巴嫩贝鲁特法国主宫医院接受了LCRCS。患者分为两组：肥胖组和非肥胖组。BMI≥30 Kg/m²用于定义肥胖患者。术后30天内的并发症是主要观察指标。使用Clavien-Dindo评分评估术后并发症的严重程度。采用卡方检验评估所收集变量之间的统计学相关性。
结果
我们确定了在本研究期间在我们机构接受LCRCS的107例患者。其中，23例为肥胖患者（21.49%）。术后30天，据报告有26例患者至少发生一种并发症。两组术后早期并发症发生率无显著差异（肥胖组26.1%，非肥胖组23.8%，P = 0.821）。肥胖并未被证明是术后早期并发症严重程度的分层风险因素（P = 0.92）。
结论
定义为BMI≥30 Kg/m²的肥胖，在LCRCS中既不是术后早期并发症的风险因素，也不是术后并发症严重程度的分层风险因素。
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