Laparoscopic Surgery for Colorectal Cancer with Severe Obesity (Body Mass Index of 35kg/m<SUP>2</SUP> or Higher): A Report of Four Cases

Takahashi Rei, Tsujinaka Shingo, Ishikawa Hideki, Maemoto Ryo, Kimura Yasuaki, Hatsuzawa Yuuri, Kakizawa Nao, Machida Erika, Tamaki Sawako, Miyakura Yasuyuki, Rikiyama Toshiki

doi:10.3862/jcoloproctology.75.129

<p>We examined four cases who underwent laparoscopic surgery for colorectal cancer with severe obesity with a body mass index (BMI) of 35 kg/m² or higher. The median age was 64 (range: 54-80) years old. There were two males and two females, and the median BMI was 41.6 kg/m² (range: 35.6-48.7). Preoperatively, an energy-restricted diet was prescribed in two cases. The surgical procedures included ileocecal resection, lower anterior resection, sigmoid colectomy, and left hemicolectomy. The median operative time was 393 (range: 335-688) minutes, the median intraoperative bleeding volume was 173.5 (range: 40-1,790) mL, and the median postoperative hospital stay was 10 (range: 7-63) days. Intraoperatively, the wound was added in one case, and the port was added in two cases. In one case of lower anterior resection, conversion to laparotomy was required due to uncontrollable intrapelvic bleeding, and anastomotic leakage occurred after surgery which was successfully managed conservatively. In laparoscopic colorectal cancer surgery for patients with severe obesity, it is important to overcome the difficulties in intraoperative surgical techniques. In addition, more data needs to be collected to assess the significance of preoperative weight loss.</p>

Laparoscopic Surgery for Colorectal Cancer with Severe Obesity (Body Mass Index of 35kg/m<SUP>2</SUP> or Higher): A Report of Four Cases

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