비만이 복강경하 저위 전방절제술에 미치는 영향 = The Impacts of Obesity on a Laparoscopic Low Anterior Resection

다국어 초록 (Multilingual Abstract)

Purpose: Obese patients are generally believed to be at increased risk for surgery compared to those who are not obese.
It was the purpose of this study to compare the short-term outcomes of a laparoscopic low anterior resection (LAR) in obese
and non-obese patients.
Methods: We retrospectively reviewed 79 patients who had undergone a laparoscopic LAR for rectal cancer between September
2002 and January 2008. The degree of obesity was based on the Body Mass Index (BMI, kg/m2). We divided the 79 patients
into two groups: the high BMI (BMI ≥25) and the low BMI (BMI <25) groups. The parameters analyzed included age, gender,
American Society of Anesthesiologists classification score, operative time, estimated blood loss, conversion rate, postoperative
complications, hospital stay, and oncologic characteristics. Statistics included the t-test and Fisher’s exact test. Statistical
significance was assessed at the 5% level (P<0.05 being statistically significant).
Results: There were no significant differences between the low BMI (n=55) and the high BMI (n=24) groups in age and gender.
The high BMI group had significantly more conversion to an open procedure (20.8% vs. 3.6%, P=0.0244). The high BMI group
and the low BMI group had no differences in blood loss, complications, hospital stay, and oncologic characteristics, but the
high BMI group had a longer operative time (244.2 min vs. 212.0 min, P=0.0035).
Conclusion: A laparoscopic LAR in obese patients had a higher conversion rate and a longer operative time, but there were
no differences in postoperative complications and oncologic characteristics. A further study based on many experiences is
needed to clarify the influence of the surgeon’s experience on the operative time and the conversion rate, and long-term
follow-up is necessary to evaluate the oncologic safety of a laparoscopic LAR in obese patients.

다국어 초록 (Multilingual Abstract)

Purpose: Obese patients are generally believed to be at increased risk for surgery compared to those who are not obese.
It was the purpose of this study to compare the short-term outcomes of a laparoscopic low anterior resection (LAR) in obese
and non-obese patients.
Methods: We retrospectively reviewed 79 patients who had undergone a laparoscopic LAR for rectal cancer between September
2002 and January 2008. The degree of obesity was based on the Body Mass Index (BMI, kg/m2). We divided the 79 patients
into two groups: the high BMI (BMI ≥25) and the low BMI (BMI <25) groups. The parameters analyzed included age, gender,
American Society of Anesthesiologists classification score, operative time, estimated blood loss, conversion rate, postoperative
complications, hospital stay, and oncologic characteristics. Statistics included the t-test and Fisher’s exact test. Statistical
significance was assessed at the 5% level (P<0.05 being statistically significant).
Results: There were no significant differences between the low BMI (n=55) and the high BMI (n=24) groups in age and gender.
The high BMI group had significantly more conversion to an open procedure (20.8% vs. 3.6%, P=0.0244). The high BMI group
and the low BMI group had no differences in blood loss, complications, hospital stay, and oncologic characteristics, but the
high BMI group had a longer operative time (244.2 min vs. 212.0 min, P=0.0035).
Conclusion: A laparoscopic LAR in obese patients had a higher conversion rate and a longer operative time, but there were
no differences in postoperative complications and oncologic characteristics. A further study based on many experiences is
needed to clarify the influence of the surgeon’s experience on the operative time and the conversion rate, and long-term
follow-up is necessary to evaluate the oncologic safety of a laparoscopic LAR in obese patients.

참고문헌 (Reference)

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