Outcomes in Laparoscopic Colectomy for Colorectal Cancer in the Obese
Background: Although laparoscopic resection is widely accepted for the surgical treatment of colorectal cancer (CRC), the impact of obesity on the potential short-term benefits of laparoscopy seems unclear since oncological outcomes must be preserved. Objectives: This review aimed to examine the published data supporting laparoscopic surgery in obese patients with localized CRC. Methods: We reviewed the relevant literature (PUBMED, EMBASE and the Cochrane databases) from 2005 to 2013 for obese patients with CRC who underwent laparoscopic surgery. Results: A total of 18 studies were included. Conversion to open surgery was higher in the obese population, without affecting oncologic long-term outcome. The harvested lymph nodes, specimen length, or resection margins were not affected by obesity. One study reported no differences in disease-free (p=0.6) and overall survival (p=0.5) between obese and non-obese patients. The anastomotic leak was similar in both groups; only one study reported a higher incidence of anastomotic leak in obese patients, but only in the mid to lower rectum. No studies reported any statistically significant differences between obese and nonobese patients in terms of mortality and time to resumption of intestinal function or oral intake. The incidence of wound infection had variable results among the studies. Conclusion: Laparoscopic surgery for localized CRC can be safe in obese patients, including preservation of oncological outcome.