30-Day Postoperative Morbidity of Emergency Surgery for Obstructive Right- and Left-Sided Colon Cancer in Obese Patients: A Multicenter Cohort Study of the French Surgical Association

Dig Surg. 2020;37(2):111-118. doi: 10.1159/000497450. Epub 2019 Apr 2.

Abstract

Background: Emergency surgery impairs postoperative outcomes in colorectal cancer patients. No study has assessed the relationship between obesity and postoperative results in this setting.

Objective: To compare the results of emergency surgery for obstructive colon cancer (OCC) in an obese patient population with those in overweight and normal weight patient groups.

Methods: From 2000 to 2015, patients undergoing emergency surgery for OCC in French surgical centers members of the French National Surgical Association were included. Three groups were defined: normal weight (body mass index [BMI] < 25.0 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obese (BMI ≥30.0 kg/m2).

Results: Of 1,241 patients, 329 (26.5%) were overweight and 143 (11.5%) were obese. Obese patients had significantly higher American society of anesthesiologists score, more cardiovascular comorbidity and more hemodynamic instability at presentation. Overall postoperative mortality and morbidity were 8 and 51%, respectively, with no difference between the 3 groups. For obese patients with left-sided OCC, stoma-related complications were significantly increased (8 vs. 5 vs. 15%, p = 0.02).

Conclusion: Compared with lower BMI patients, obese patients with OCC had a more severe presentation at admission but similar surgical management. Obesity did not increase 30-day postoperative morbidity except stoma-related complications for those with left-sided OCC.

Keywords: Colon cancer; Colonic obstruction; Emergency surgery; Obesity.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical
  • Case-Control Studies
  • Colectomy*
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / surgery*
  • Colostomy*
  • Emergencies
  • Female
  • Follow-Up Studies
  • France
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery*
  • Male
  • Middle Aged
  • Obesity / complications*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome