{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:42:40Z","timestamp":1788932560789,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T00:00:00Z","timestamp":1525392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cabrini Foundation"},{"name":"Colorectal Surgical Society of Australia and New Zealand Foundation"},{"name":"ADIPOSe trial"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Obesity is common in Western countries and its prevalence is increasing. Colorectal cancer is common, and surgery for colorectal cancer is technically more challenging in obese patients. Laparoscopic surgery for colon cancer has been shown to be oncologically equivalent, with improved short\u2010 term outcomes. Laparoscopic surgery for rectal cancer has proven technically challenging, and recent results have raised concerns about oncological equivalence. Our aim was to evaluate the effect of body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) on the clinical and oncological outcomes of surgery for colorectal cancer, including the rate at which laparoscopic surgery is attempted and the rate at which laparoscopic surgery is converted to open surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective analysis of prospectively collected data from two tertiary institutions was performed. Data were obtained from the Cabrini Monash University colorectal neoplasia database for patients having surgical resection for colon and rectal cancers between 1 January 2010 and 30 June 2015. Surgical and medical complications, tumour recurrence and overall survival and laparoscopic surgery and conversion rates were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This large case series of 1464 patients undergoing elective surgery for colorectal cancer has demonstrated that an elevated <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> is associated with a lower likelihood of attempting laparoscopic surgery and a higher conversion rate to open surgery when laparoscopy is attempted. Conversion was 1.9 times more likely in obese patients with colon cancer and 4.1 times more likely in obese patients with rectal cancer. The critical <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> for colon cancer patients was &gt; 35 kg\/m<jats:sup>2<\/jats:sup>, and for rectal cancer patients &gt; 30 kg\/m<jats:sup>2<\/jats:sup>. Obesity is also associated with increased rates of surgical complications, including anastomotic leakage and wound complications. Pathological parameters, tumour recurrence and survival were not affected by elevated <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the surgical management of colorectal cancer, obesity is associated with a lower likelihood of laparoscopic surgery being attempted, a higher likelihood of conversion to open surgery when laparoscopic surgery is attempted, and a higher rate of surgical complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14107","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T01:53:58Z","timestamp":1522029238000},"page":"778-788","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["The effect of increasing body mass index on laparoscopic surgery for colon and rectal cancer"],"prefix":"10.1111","volume":"20","author":[{"given":"S.","family":"Bell","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health Prahran Victoria Australia"},{"name":"Department of Surgery Cabrini Hospital Cabrini Monash University Malvern Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1392-2480","authenticated-orcid":false,"given":"J. C.","family":"Kong","sequence":"additional","affiliation":[{"name":"Division of Cancer Surgery Peter MacCallum Cancer Centre University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Wale","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health Prahran Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Staples","sequence":"additional","affiliation":[{"name":"Monash Department of Clinical Epidemiology Cabrini Hospital Malvern Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Oliva","sequence":"additional","affiliation":[{"name":"Department of Surgery Cabrini Hospital Cabrini Monash University Malvern Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Department of Surgery Cabrini Hospital Cabrini Monash University Malvern Australia"},{"name":"Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Mc Murrick","sequence":"additional","affiliation":[{"name":"Department of Surgery Cabrini Hospital Cabrini Monash University Malvern Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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