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Obesity Selectively Increases Intraoperative Risk in Left-Sided Colon Cancer Surgery: A Retrospective Cohort Study.

Simon Xu1, Rathin Gosavi1,2, Yat Cheung Chung1

  • 1Department of Colorectal Surgery, Monash Health, David Street, Dandenong, Melbourne, VIC, 3193, Australia.

International Journal of Colorectal Disease
|August 25, 2025
PubMed
Summary
This summary is machine-generated.

Obesity did not increase overall risks for colon cancer surgery. However, obese patients undergoing left-sided colectomy faced higher intraoperative complications and ICU admission risks, suggesting tailored risk assessment.

Keywords:
BMIColon cancerObesityPostoperative complicationsSurgical outcomes

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Obesity Medicine

Background:

  • Obesity is commonly considered a risk factor for poor surgical outcomes.
  • This study investigates the independent impact of obesity on colon cancer resection outcomes.
  • The research also examines if these effects differ based on the anatomical location of the colon cancer.

Purpose of the Study:

  • To determine if obesity (BMI ≥ 30 kg/m²) independently influences intraoperative and postoperative outcomes in colon cancer resection.
  • To assess whether the impact of obesity on surgical outcomes varies by the anatomical subsite of the colon resection.

Main Methods:

  • A retrospective cohort study of 737 patients undergoing colon cancer resection from 2015-2022.
  • Patients were stratified by BMI (≥ 30 vs. < 30 kg/m²), urgency (elective/emergency), and anatomical subsite (right/left-sided).
  • Multivariate logistic regression analyzed intraoperative complications, severe postoperative morbidity, conversion to open surgery, ICU admission, and 30-day mortality.

Main Results:

  • Obesity was not linked to increased overall intraoperative complications, severe postoperative morbidity, conversion rates, or 30-day mortality.
  • In elective cases, obesity correlated with higher ICU admission (aOR 1.82).
  • In emergent cases, obesity was associated with more intraoperative complications (aOR 2.18).
  • Left-sided colectomy in obese patients showed increased intraoperative complications (aOR 1.89) and ICU admission (aOR 3.17), unlike right-sided resections.

Conclusions:

  • Overall, obesity does not appear to be an independent risk factor for adverse outcomes in colon cancer surgery.
  • However, obesity is independently associated with increased perioperative risks, specifically for left-sided colon resections.
  • Findings advocate for a refined approach to surgical planning and risk stratification in obese patients undergoing colon cancer surgery.