South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Department of Surgery, Bankstown-Lidcombe Hospital, Sydney, Australia.
Int J Colorectal Dis. 2023 Jun 8;38(1):163. doi: 10.1007/s00384-023-04447-0.
Patients with obesity undergoing rectal cancer surgery may have an increased risk of developing complications, though evidence is inconclusive. The aim of this study was to determine the direct impact of obesity on postoperative outcomes using data from a large clinical registry.
The Binational Colorectal Cancer Audit registry was used to identify patients who underwent rectal cancer surgery in Australia and New Zealand from 2007-2021. Primary outcomes were inpatient surgical and medical complications. Logistic regression models were developed to describe the association between body-mass index (BMI) and outcomes.
Among 3,708 patients (median age 66 years [IQR 56.75-75], 65.0% male), 2.0% had a BMI < 18.5 kg/m, 35.4% had a BMI of 18.5-24.9 kg/m, 37.6% had a BMI of 25.0-29.9 kg/m, 16.7% had a BMI of 30.0-34.9 kg/m, and 8.2% had a BMI ≥ 35.0 kg/m. Surgical complications occurred in 27.7% of patients with a BMI of 18.5-24.9 kg/m, 26.6% of patients with a BMI of 25.0-29.9 kg/m (OR 0.91, 95% CI 0.76-1.10), 28.5% with a BMI of 30.0-34.9 kg/m (OR 0.96, 95% CI 0.76-1.21), and 33.2% with a BMI ≥ 35.0 kg/m (OR 1.27, 95% CI 0.94-1.71). Modelling BMI as a continuous variable confirmed a J-shaped relationship. The association between BMI and medical complications was more linear.
Risk of postoperative complications is increased in patients with obesity undergoing rectal cancer surgery.
接受直肠癌手术的肥胖患者可能会增加发生并发症的风险，但证据尚无定论。本研究的目的是使用来自大型临床注册中心的数据来确定肥胖对术后结果的直接影响。
使用澳大利亚和新西兰的国家结直肠癌症审核登记处来确定 2007 年至 2021 年间接受直肠癌手术的患者。主要结果是住院期间手术和医疗并发症。使用逻辑回归模型来描述体重指数（BMI）与结局之间的关系。
在 3708 名患者中（中位年龄 66 岁[IQR 56.75-75]，65.0%为男性），2.0%的 BMI<18.5kg/m2，35.4%的 BMI 为 18.5-24.9kg/m2，37.6%的 BMI 为 25.0-29.9kg/m2，16.7%的 BMI 为 30.0-34.9kg/m2，8.2%的 BMI≥35.0kg/m2。BMI 为 18.5-24.9kg/m2 的患者中，27.7%发生手术并发症，BMI 为 25.0-29.9kg/m2 的患者中，26.6%（比值比 0.91，95%CI 0.76-1.10）发生手术并发症，BMI 为 30.0-34.9kg/m2 的患者中，28.5%（比值比 0.96，95%CI 0.76-1.21）发生手术并发症，BMI≥35.0kg/m2 的患者中，33.2%（比值比 1.27，95%CI 0.94-1.71）发生手术并发症。将 BMI 建模为连续变量，证实了一种 J 形关系。BMI 与医疗并发症之间的关系更为线性。
接受直肠癌手术的肥胖患者发生术后并发症的风险增加。
