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  1. Home
  3. Risk Factors Of Bleeding During Rectal Cancer Surgery In Obese Patients In Japan.
  1. Home
  3. Risk Factors Of Bleeding During Rectal Cancer Surgery In Obese Patients In Japan.

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Risk factors of bleeding during rectal cancer surgery in obese patients in Japan.

Yasuhiro Ishiyama1, Yasumitsu Hirano1, Manabu Shiozawa2

  • 1Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan.

Asian Journal of Endoscopic Surgery
|May 1, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Obese patients undergoing rectal cancer surgery face higher risks of major bleeding. Key risk factors include older age, laparotomy, longer operative times, and multivisceral resection.

Keywords:
intraoperative bleedingobesityrectal cancer

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Area of Science:

  • Colorectal surgery
  • Surgical oncology
  • Obesity research

Background:

  • Laparoscopic surgery for rectal cancer offers reduced complications and bleeding versus laparotomy.
  • Obesity is a known risk factor for surgical complexity, potentially increasing complications and operative time.

Purpose of the Study:

  • To identify risk factors for major intraoperative bleeding in obese patients undergoing rectal cancer surgery.
  • To compare bleeding risk between laparoscopic surgery and laparotomy in this patient cohort.

Main Methods:

  • Retrospective analysis of 517 obese patients (BMI ≥25 kg/m²) with stage II/III rectal cancer undergoing surgery between 2009-2013.
  • Patients were stratified into major (>500 mL) and minor (≤500 mL) bleeding groups.
  • Univariate and multivariate analyses were performed to identify risk factors for major bleeding.

Main Results:

  • 19.9% of patients experienced major bleeding.
  • Major bleeding was associated with longer operative times and larger tumor size.
  • Multivariate analysis identified age >65 years, laparotomy, operative time >300 min, and multivisceral resection as significant risk factors for massive bleeding.

Conclusions:

  • Advanced age, open laparotomy, prolonged operative duration, and extensive surgical resection are significant risk factors for massive bleeding in obese patients with rectal cancer.
  • These findings highlight the importance of careful patient selection and surgical planning to mitigate bleeding risks in this population.