2023-05-08 22:11:14
“Obesity increases the risk of infection, blood clots and kidney disease complications… Surgery should be performed after losing weight as much as possible”
Research has shown that being overweight is more likely to cause complications after various surgeries and to be re-hospitalized.
A research team at the University of Colorado in the United States collected and analyzed data from about 6 million American patients who underwent various surgeries. About 45% of these patients were obese. They underwent various surgeries in neurosurgery, orthopedics, thoracic surgery, vascular surgery, plastic surgery, otolaryngology, urology, and obstetrics and gynecology.
As a result of the study, it was found that obese patients were much more likely to be readmitted to the hospital due to complications such as infection, blood clots (blood clots) and kidney disease (kidney failure) after surgery than normal weight patients. Also, for the same type of surgery, obese patients took 89 minutes (median), 6 minutes longer than normal weight patients (83 minutes). However, except for severely obese patients with a body mass index (BMI, unit kg/m2) of 40 or more, obese patients did not have a higher risk of postoperative complications, such as bleeding, stroke, or lung problems, than those with normal weight. A normal BMI ranges from 18.5 to 24.9.
Professor Robert Meguid (thoracic surgery), lead author of the study, said, “It is analyzed that complications in obese patients are caused by body inflammation, blood flow changes, and lack of activity.” It is not easy for patients who are obese (or overweight) to get up and move after surgery. Increased risk of blood clots in the legs. Blood clots make it more difficult to walk. Obesity, along with inflammatory conditions in the body, increases the risk of complications. When infected with various viruses and bacteria, adipose tissue does not heal well and blood flow is not as good as muscle tissue. Blood flow changes in obese patients also act as a factor that increases the risk of kidney disease complications.
Professor Meguid said, “I feel that it is technically more difficult to operate on obese patients even if a thoracic surgeon performs lung cancer and esophageal cancer of the chest.” As a result, obese patients have to stay in the operating room longer and may be exposed to more problems. During surgery, the patient’s body temperature is lowered. Hyperthermia in the operating room is closely related to an increased risk of infection.
“Patients who are overweight need to be in peak physical condition before undergoing surgery,” he said. You must not smoke or drink alcohol for several weeks prior to surgery.” In particular, he emphasized, “If surgery can be postponed, it is desirable for obese patients to lose weight before undergoing surgery.”
Dr. Mitchell Roslin (bariatric surgery) at Northern West Chester Hospital in New York, who was not involved in the study, said, “The body of an obese patient is usually considered to be older than his or her age.” “Obese patients are more likely to suffer from metabolic syndrome, such as hypertension, hypercholesterolemia, and diabetes, which can lead to complications of kidney disease. Hypertension is related to vascular disease, and inflammation to blood clots.”
The findings (The association between obesity and postoperative outcomes in a broad surgical population: A 7-year American College of Surgeons National Surgical Quality Improvement analysis) were published in the Journal of Surgery.
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