P383 Overweight impairs short-term outcomes of laparoscopic IBD surgery. A comparative analysis of 639 consecutive patients.
L. Maggiori*1, M. Couturier1, X. Tréton2, Y. Bouhnik2, Y. Panis1
1Beaujon Hospital, Colorectal Surgery, Clichy, France, 2Beaujon Hospital, Gastroenterology, Clichy, France
This study aimed to assess the impact of body Mass Index (BMI) on inflammatory bowel disease (IBD) laparoscopic surgery outcome.
From 1998 to 2013, all patients who underwent a laparoscopic colorectal resection performed for IBD were prospectively included. This cohort was split in 3 groups, according to the body mas index (BMI) of the patients: under-weighted patients (BMI ≤ 18.5), normally weighted patients (18.5 < BMI < 25), and over-weighted patients (BMI ≥ 25).
639 consecutive laparoscopic colorectal resections for IBD were analyzed, including 324 ileocolonic resections (51%), 130 subtotal colectomies (20%), 147 ileal pouch-anal anastomoses (IPAA) (23%), 21 segmental colectomies (3%), and 17 abdominoperineal resections (3%).
Compared to normally weighted patients, over-weighted patients showed a significantly increased intra-abdominal septic complication (IASC) rate (16 vs. 10%, p=0.038) but similar length of hospital stay, conversion rate, overall postoperative morbidity rate, severe (Clavien-Dindo ≥ 3) postoperative morbidity rate, and reintervention rate. Conversely, outcomes of under-weighted patients showed no difference, compared to those of normally weighted patients.
Per-procedure analysis showed similar outcomes between the 3 groups for ileocolic resection and subtotal colectomy. For IPAA, over-weighted patients had significantly increased severe postoperative morbidity (34 vs. 14%, p=0.008) and IASC (34 vs. 13%, p=0.004) rates, compared to normally weighted patients, whereas underweighted and normally weighted patients had similar outcomes.
Overweight significantly impairs short-term outcomes of laparoscopic IBD surgery, especially after IPAA.