Esophageal cancer surgery safe in the morbidly obese
NEWS IN BRIEF — Posted Feb. 19, 2007
Patients with profound obesity who receive a transhiatal esophagectomy have similar outcomes as those who are not as overweight, according to a study presented at the Society of Thoracic Surgeons' meeting in San Diego in January.
This question is considered important, because the increasing obesity rate is translating to a rising number of cancers of the esophagus linked to reflux, but evidence has been lacking as to the safety of standard treatments in those with excess weight.
"The type of patient who currently develops esophageal cancer has changed dramatically in the last 20 years," said Mark Orringer, MD, one of the authors and the John Alexander Distinguished Professor of Surgery at the University of Michigan Medical School in Ann Arbor. "Profoundly obese patients undergoing a [transhiatal esophagectomy] at a high-volume center can have surprisingly and acceptably low morbidity and mortality rates, similar to those of non-obese individuals."
Researchers retrospectively analyzed data on 133 morbidly obese patients and compared them with another 133 who had a body mass index between 18.5 and 30. Those with a BMI greater than 35 had a higher risk of intra-operative blood loss, need for partial sternotomy and recurrent laryngeal nerve injury. The two groups had similar rates of wound infection and death. Functionality after surgery also was comparable.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/02/19/hlbf0219.htm.