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GIUSEPPE SALAMONE

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

  • Autori: Blanco-Colino R, Lee S, Kamarajah SK, Vasko P, Kuiper SZ, Farina V, Chapman SJ, Drake TM, Gavagna L, Pasquali S, Pata F, Pellino G, de la Rosa-Estadella M, Stellingwerf ME, Stijns RCH, Borrellas A, Golding D, Ngaage M, Van Tol RR, de Groof J, de Wilt H, Bemelman WA, McNamee L, Espin-Basany E, Emre Baki B, Gecim IE, Can Tatar O, Bach S, Bhangu A, Bresges K, Burke J, Claireaux HA, Fearnhead N, Fitzgerald JE, Gallagher S, Glasbey JC, Gundogan B, Harrison EM, Hernon J, Khatri C, Kong CY, Lyons A, Mohan M, Morton D, Pinkney TD, Arezzo A, Foppa C, Morino M, Rubbini M, Selvaggi F, Sensi B, Sica G, Orhalmi J, Naccari P, Sgrò A, Burger BHCM, Fares DA, Spijkerman R, van Elst TR, Wiersema R, Stassen LPS, Rodriguez Garcia R, Özkan BB, Tavuz AI, Demirci ZS, Baki BE, Choi PJ, O'Sullivan H, Salman M, Simioni A, Colombo F, Turati L, Cazzola FE, Gallo G, Perrotta G, Papandrea M, Naccari PM, Menduni N, Rossi E, Chetta N, Romeo F, Giordano F, Randisi B, Curletti G, Kuiper J, Costa A, Marcos Rodrigo A, Sanchez A, Varo Muñoz A, Martinez Rios CE, Aliseda-Jover D, Fernandez Nieto D, Alvarez Reyes I, Dominguez Rodriguez LM, Hernandez Ros MI, Esteban Sinovas O, Bartrina Soler P, Villarejo Campos P, Laguna Román S, Fontanet-Soler S, Raurich-Leandro J, Dominguez-Prieto V, Segura-Sampedro JJ, Alconchel-Gago F, Salazar-García C, Gezen AE, Sahin A, Atasoy H, Yuksek B, Arslan E, Ozmen BB, Sen AY, Erol HI, Ucar E, Aktas MK, Yurdaor SS, Mermer S, Seyhan U, Tosun V, Gunaydin Y, Ekinci ZB, Yazkan Z, Choi J, Yeoh TSL, Jones CS, Venturini S, Saat MI, Loo J, Pike G, Davies SC, Kabariti R, Olivier J, Hurný M, Žebrák R, Machačová A, Schulzová M, Smolák P, Široká M, Palyzová H, Jaroš J, Dušek T, Šimáčková B, Bartoš M, Sotona O, Pös M, Karásek D, Higgins P, Hacking S, Arora E, Coughlan G, Palanivail N, Quill S, Zhang AA, Malak M, Maan DS, Cheema J, Goh AWJ, Shamsul Badrin AK, Guinness F, Howard James N, Neary A, Sebaoui S, Gilroy D, Petrov G, Craven K, MacDonald A, Redmond A, Brennan D, Roche D, O'Dwyer M, Collins P, Edwards S, Doyle J, Tiedt L, Arthurs B, O'Byrne L, Kiely A, Glynn M, Sproule L, Heaney A, Li Hi Shing S, Goh W, Al-Nasser Z, Al-Nasser A, Teh JW, De Boni D, Goldin E, Ciccioli E, Vendramin E, Marchese N, Bruno M, Vinci A, Harder G, Morandi V, Magnoli M, Suppa A, Palmieri A, Martorana M, Sette M, Balagna P, Cruciani C, Corte M, Ciano P, Bagaglini G, Montuori M, Di Benedetto L, Arcudi C, Pezzuto R, Saraceno F, Milana F, Franceschilli M, Rizzi A, Sampietro G, Rampulla V, Bianco F, Boschetti ME, Ghignone F, Bianchini S, Esposto R, Riva L, Riva M, Cannavò M, Arrigo A, Giavarini L, Colombo EM, Trompetto M, Clerico G, Catalano M, Dosa T, El Mabruk M, Barone V, Pallara E, Pasqualoni M, Caudullo G, Mastandrea Bonaviri GN, Muro M, Pistola I, Verardi L, Ferrara D, Gerardi S, Remore LM, Belia F, Del Coco F, Larotonda C, Botrugno EM, Cammarota A, Di Girolami L, Laterza V, Laurino A, Paolo G, Santocchi P, Puccioni C, Truma A, Giardino FR, Giuffrida A, Ripa M, Cautiero R, Patturelli M, Capozzolo A, Selvaggi L, Facchiano A, Milazzo LF, Papazachariou SK, Pattapola V, Anania G, Feo C, Bellinato M, Priani P, Zigiotto D, Troia A, Vable T, Piran G, Targa S, Pulpito S, Tagariello F, Fasano A, Anconelli D, Castiglione F, Tognolo L, Lopez G, Campion A, Tarantino M, Sacco R, Sammarco G, Palmisano S, Giacca M, Rocco I, Bellio G, Favero A, Raimondi P, Pantalone MR, De Nardi P, Notarnicola M, Picciariello A, Licari L, Parinisi Z, Fazzotta S, Ciciliot M, Reggiani L, Mariani F, Aonzo P, Checcacci P, Montanelli P, Guerra F, Skalamera I, Staderini F, Grandi S, Nelli T, de Boer DV, van der Pool AEM, Janssen TL, El-Atmani S, van Verschuer VMT, Poelman M, Dronkers WJ, van Steensel L, Toorenvliet BR, Duinhouwer LE, Vermaas M, Ter Bruggen FFJA, Hogendoorn W, van der Harst E, van Rijckevorsel VAJIM, Bayoumy AB, Lap CR, Gooszen JAH, Abdulrahman N, de Roy van Zuidewijn D, de Groof EJ, Zijlmans JL, van Dalen ASHM, Bos K, Musters GD, Looijen RC, F
  • Anno di pubblicazione: 2018
  • Tipologia: Articolo in rivista (Articolo in rivista)
  • OA Link: http://hdl.handle.net/10447/294460

Abstract

Aim: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data. Methods: This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results: This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients. Conclusions: In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.