Impact of obesity on early postoperative complications of esophageal cancer / 中国基层医药

ABSTRACT

Objective To investigate the effect of obesity on the early complications after esophageal cancer operation.Methods Clinical data of 327 patients who had esophageal cancer operation in our hospital from August 2012 to September 2015 were retrospectively analyzed.The patients were divided into 4 groupslean group(n =75), normal group(n =120),overweight group(n =103)and obesity group(n =29)by body mass index(BMI).The impact of obesity on early complications of esophageal carcinoma after surgery was analyzed.Results The operation time of the lean group,normal group,overweight group and obesity group were (257.8 ±52.6 )min,(289.3 ± 48.7)min,(321.5 ±55.9)min,(367.9 ±50.2)min respectively.The operation time was increased with the increase of BMI (F =13.397,P =0.000).The incidence rates of incision infection,empyema,hoarseness,diaphragmatic hernia,postoperative bleeding,chylous fistula,pulmonary complication were 5.3%,1.3%,1.3%,1.3%,2.7%, 2.7%,16.0% in the lean group,5.0%,1.6%,1.6%,1.3%,1.6%,1.6%,17.5% in the normal group,5.8%, 1.9%,0.9%,1.9%,1.9%,1.9%,1.9% in the overweight group,10.3%,3.4%,0.0%,3.4%,3.4%,0.0%, 13.8% in the obesity group.No significant differences were found about the hospital days,wound infection,empyema, hoarseness,diaphragmatic hernia,operation hemorrhage,chylous fistula,pulmonary complications among the 4 groups (all P >0.05 ).The incidence rates of cardiovascular complications and anastomotic leakage after operation were 0.0%,4.0% in the lean group,1.9%,5.0% in the normal group,6.8%,9.7% in the overweight group,13.8%, 17.2% in the obesity group.The incidence of cardiovascular complications,postoperative anastomotic leakage increased with the increase of BMI.The differences of the four groups were statistically significant(F =1.675,1.054, all P <0.05).Conclusion Obesity can increase the incidence of early postoperative complications in patients with esophageal cancer.But obesity is not a contraindication of surgery for esophageal cancer,but obese patients should be more carefully treated in the perioperative period.