Journal de chirurgie universelle

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Abstrait

Does Body Mass Index Important in Preoperative Evaluation of Patients Electing Gastrointestinal Surgery?

Michele Carron

At Queen Elizabeth Hospital in Birmingham (QEHB), there is no specific procedure for stratifying patients by body mass index (BMI). This study aimed to evaluate the outcome after gastrointestinal surgery. Patients undergoing gastrointestinal surgery who attended the Pre-Assessment Screening (PAS) clinic from August to September 2016 at QEHB were identified. The primary outcome was postoperative complications. Secondary outcomes were major complications and 30-day readmission rates. Result. Of the 368 pre-evaluated patients, 31% (116/368) were overweight and 35% (130/368) were obese. Median age was 57 years (range: 17-93). There was no difference in BMI between low-risk and high-risk clinics. Patients in high-risk clinics have significantly higher morbidity, major surgical grade, and malignancy as an indication for surgery. The overall complication rate was 14% (52/368), of which 3% (10/368) had serious complications (Clavien-Dindo Grade III-IV). Although BMI was associated with comorbidities and ASA level, it was not associated with worse outcomes. Patients presenting to a highrisk clinic have a significantly higher rate of complications. Findings the degree of surgery is considered an independent risk factor for complication rates. It is not reasonable to use BMI as an independent factor for the extent of prior assessment in our cohort. The prevalence of obesity is rapidly increasing in developed countries, with prevalence rates in the US (35.7%) and the UK (26.1%) expected to double. Estimates predict that up to 66% of patients undergoing surgery in the UK are overweight. Current conflicting evidence regarding the impact of obesity on postoperative complications following major surgery. Multicenter studies of specific patient populations in Japan, Denmark, Switzerland, and the United States have associated obesity with worse or neutral short-term postoperative outcomes.

Body mass index; rectal neoplasms; Pelvic exenteration; Treatment outcome