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Single-port laparoscopic colorectal surgery appears safe in patients with obesity
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Patients with obesity who underwent right hemicolectomy with single-port laparoscopy had comparable short-term outcomes and complications to nonobese patients in a recent study.
To test the hypothesis that single-port laparoscopy used before right hemicolectomy would be safe and result in acceptable outcomes for patients with obesity, researchers performed a retrospective analysis of 118 patients who underwent single-port laparoscopy before a right hemicolectomy from July 2009 to June 2014 at a Veterans Affairs facility with a high-volume, academic colorectal surgery practice. Patients were grouped based on BMI (30 or greater, n = 55; less than 30, n = 63), and the primary outcomes were 30-day complications and oncologic resection parameters.
There were no significant differences in age, American Society of Anesthesiologists classification, number of prior abdominal surgeries, cancer as the indication for surgery, conversion to open or multiport laparoscopy, intraoperative blood loss or length of stay between groups. The mean duration of single-port laparoscopy was 132 minutes for obese patients compared with 107 minutes for nonobese patients (P < .001).
Four patients in the obese group had a wound infection compared with no patients in the nonobese group, and mean specimen length was longer in obese patients (both P = .04). There were no significant differences in complications, anastomotic leak rate, mean number of lymph nodes harvested or rate of positive margins.
“Our results indicate that a BMI of 30 or higher does not preclude a patient from undergoing [single-port laparoscopy],” the researchers concluded. “However, our study does not further categorize the class of obesity, and it would be useful to evaluate the results of [single-port laparoscopy] in the morbidly obese and super obese populations. We also recognize that the power of our study is limited by the retrospective nature of the study, and therefore, our data collection is ongoing.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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