دورية أكاديمية

Outcomes after laparoscopic intestinal resection in obese versus non-obese patients.

التفاصيل البيبلوغرافية
العنوان: Outcomes after laparoscopic intestinal resection in obese versus non-obese patients.
المؤلفون: Khoury W; Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA., Stocchi L, Geisler D
المصدر: The British journal of surgery [Br J Surg] 2011 Feb; Vol. 98 (2), pp. 293-8.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 0372553 Publication Model: Print Cited Medium: Internet ISSN: 1365-2168 (Electronic) Linking ISSN: 00071323 NLM ISO Abbreviation: Br J Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2021- : [Oxford] : Oxford University Press
Original Publication: [Bristol, England : Baltimore : John Wright & Sons ; Williams & Wilkins Co.
مواضيع طبية MeSH: Laparotomy*, Intestinal Diseases/*surgery , Obesity/*complications, Blood Loss, Surgical ; Body Mass Index ; Case-Control Studies ; Female ; Humans ; Intestinal Diseases/complications ; Length of Stay ; Male ; Middle Aged ; Postoperative Care ; Treatment Outcome
مستخلص: Background: The degree of benefit derived from laparoscopic bowel resection in obese compared with non-obese patients is poorly understood.
Methods: A total of 436 obese patients (body mass index (BMI) at least 30 kg/m(2), mean 34·9 kg/m(2)) who underwent laparoscopic bowel resection during 1992-2008 were identified from a prospective database. An equal number of non-obese patients (mean BMI 24·8 kg/m(2)) was case-matched by age, sex, year of surgery, American Society of Anesthesiologists score, diagnosis and type of operation. Patients with previous major abdominal surgery were excluded. Postoperative morbidity and recovery were compared between obese and non-obese patients.
Results: Mean duration of operation (171·5 versus 157·3 min; P = 0·017), estimated blood loss (EBL; 224·9 versus 164·6 ml; P = 0·001) and conversion rate (13·3 versus 7·1 per cent; P = 0·003) were increased significantly in obese patients. Overall postoperative morbidity was also greater (32·1 versus 25·7 per cent; P = 0·041), particularly wound infection rate (10·6 versus 4·8 per cent; P = 0·002). Among laparoscopically completed operations, obese patients had higher rates of overall morbidity (31·5 versus 24·2 per cent; P = 0·026) and wound infection (10·2 versus 4·4 per cent; P = 0·002). Conversion was associated with increased EBL, intraoperative complications, overall morbidity and length of stay in both groups. The effect of conversion in worsening outcomes was comparable in obese and non-obese patients, except for a greater increase in incision length (11·0 versus 8·0 cm; P = 0·001) and EBL (304·8 versus 89·8 ml; P = 0·001) in obese patients.
Conclusion: Laparoscopic bowel resection results in greater morbidity in obese than in non-obese individuals. This difference remains comparable whether the procedure is completed laparoscopically or converted.
تواريخ الأحداث: Date Created: 20101127 Date Completed: 20110131 Latest Revision: 20101224
رمز التحديث: 20240829
DOI: 10.1002/bjs.7313
PMID: 21110332
قاعدة البيانات: MEDLINE
الوصف
تدمد:1365-2168
DOI:10.1002/bjs.7313