Cited by 631Cardiac, Anesthesia and Surgical OutcomesObesity, Physical Activity, DietBariatric Surgery and Outcomes

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Obesity in general elective surgery

Dindo, Daniel, Muller, Markus K, Weber, Markus, Clavien, Pierre-Alain·2003·The Lancet

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Abstract

Background Obese patients are generally believed to be at a higher risk for surgery than those who are not obese, although convincing data are lacking.Methods We prospectively investigated a cohort of 6336 patients undergoing general elective surgery at our institution to assess whether obesity affects the outcome of surgery. Exclusion criteria were emergency, vascular, thoracic, and bariatric operations; transplantation procedures; patients under immunosuppression; and operations done under local anaesthesia. Postoperative morbidity was analysed for non-obese and obese patients (body-mass index <30 kg/m(2) vs >or=30 kg/m(2)). Obesity was further stratified into mild obesity (30.0-34.9 kg/m(2)) and severe obesity (>or=35 kg/m(2)). Risk factors were analysed with univariate and multivariate models.Findings The cohort consisted of 6336 patients, of whom 808 (13%) were obese, 569 (9%) were mildly obese, and 239 (4%) had severe obesity. The morbidity rates in patients who were obese compared with those who were not were much the same (122 [15.1%] of 808 vs 901 [16.3%] of 5528; p=0.26), with the exception of an increased incidence of wound infections after open surgery in patients who were obese (17 [4%] of 431 vs 92 [3%] of 3555, p=0.03). Incidence of complications did not differ between patients who were mildly obese (91 [16.0%] of 569), severely obese (36 [15.1%] of 239), and non-obese (901 [16.3%] of 5528; p=0.19). In multivariate regression analyses, obesity was not a risk factor for development of postoperative complications. Of note, the additional medical resource use as estimated by a new classification of complications showed no differences between patients who were and were not obese.Interpretation Obesity alone is not a risk factor for postoperative complications. The regressive attitude towards general surgery in obese patients is no longer justified.

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Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001
Mokdad, A. H., Ford, E. S., Bowman, B. A., Dietz, W. H., Vinicor, F., Bales, V. S., & Marks, J. S. (2003) · JAMA · doi:10.1001/jama.289.1.76 · Cited by 5,866
Obesity as a medical problem
Kopelman, P. G. (2000) · Nature · doi:10.1038/35007508 · Cited by 4,795
Body Weight and Mortality among Women
Manson, J. E., Willett, W. C., Stampfer, M. J., Colditz, G. A., Hunter, D. J., Hankinson, S. E., Hennekens, C. H., & Speizer, F. E. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509143331101 · Cited by 2,005
Proposed classification of complications of surgery with examples of utility in cholecystectomy.
Clavien, P., Sanabria, J. R., & Strasberg, S. M. (1992) · PubMed · Cited by 1,629
Medical Hazards of Obesity
Pi‐Sunyer, F. X. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-119-7_part_2-199310011-00006 · Cited by 1,366
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Nguyen, N. T., Goldman, C. D., Rosenquist, C. J., Arango, A., Cole, C., Lee, S. J., & Wolfe, B. M. (2001) · Annals of Surgery · doi:10.1097/00000658-200109000-00002 · Cited by 1,039
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Engelman, D. T., Adams, D. H., Byrne, J. G., Aranki, S. F., Collins, J. J., Couper, G. S., Allred, E. N., Cohn, L. H., & Rizzo, R. J. (1999) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(99)70056-5 · Cited by 491
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Nair, S. P., Verma, S., & Thuluvath, P. J. (2002) · Hepatology · doi:10.1053/jhep.2002.30318 · Cited by 419

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Laparoscopic colorectal surgery in obese and nonobese patients: Do differences in body mass indices lead to different outcomes?
Schwandner, O., Farke, S., Schiedeck, T. H. K., & Bruch, H. ‐. (2004) · Surgical Endoscopy · doi:10.1007/s00464-003-9259-6 · Cited by 95
Obesity, outcomes and quality of care: body mass index increases the risk of wound-related complications in colon cancer surgery
Amri, R., Bordeianou, L., Sylla, P. A., & Berger, D. L. (2013) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2013.05.016 · Cited by 93
Prolonged waiting times for liver transplantation in obese patients
Segev, D. L., Thompson, R. E., Locke, J. E., Simpkins, C. E., Thuluvath, P. J., Montgomery, R. A., & Maley, W. R. (2008) · Annals of Surgery · doi:10.1097/sla.0b013e31818a01ef · Cited by 91
Positive nasal culture of methicillin-resistantStaphylococcus aureus(MRSA) is a risk factor for surgical site infection in orthopedics
Yano, K., Minoda, Y., Sakawa, A., Kuwano, Y., Kondo, K., Fukushima, W., & Tada, K. (2009) · Acta Orthopaedica · doi:10.3109/17453670903110675 · Cited by 91
Medical and Financial Risks Associated With Surgery in the Elderly Obese
Silber, J. H., Rosenbaum, P. R., Kelz, R. R., Reinke, C. E., Neuman, M. D., Ross, R. N., Even‐Shoshan, O., David, G., Saynisch, P. A., Kyle, F. A., et al. (2012) · Annals of Surgery · doi:10.1097/sla.0b013e31825375ef · Cited by 89
IMPACT OF BODY HABITUS ON PERIOPERATIVE MORBIDITY ASSOCIATED WITH FUSION OF THE THORACOLUMBAR AND LUMBAR SPINE
Shamji, M. F., Parker, S., Cook, C. E., Pietrobon, R. S., Brown, C., & Isaacs, R. E. (2009) · Neurosurgery · doi:10.1227/01.neu.0000350863.69524.8e · Cited by 89
The impact of obesity on outcomes of laparoscopic surgery for colorectal cancer in Asians
Park, J. W., Lim, S.-W., Choi, H. S., Jeong, S., Oh, J. H., & Lim, S. (2009) · Surgical Endoscopy · doi:10.1007/s00464-009-0829-0 · Cited by 88
Cefazolin Dosing for Surgical Prophylaxis in Morbidly Obese Patients
Ho, V. P., Nicolau, D. P., Dakin, G. F., Pomp, A., Rich, B. S., Towe, C. W., & Barie, P. S. (2012) · Surgical Infections · doi:10.1089/sur.2010.097 · Cited by 85
Impact of Increased Body Mass Index on Outcomes of Elective Spinal Surgery
Seicean, A., Alan, N., Seicean, S., Worwag, M., Neuhauser, D. B., Benzel, E. C., & Weil, R. J. (2014) · Spine · doi:10.1097/brs.0000000000000435 · Cited by 85
Robotic versus conventional laparoscopic distal pancreatic resection: a systematic review and meta-analysis
Kamarajah, S. K., Sutandi, N., Robinson, S. R., French, J., & White, S. A. (2019) · HPB · doi:10.1016/j.hpb.2019.02.020 · Cited by 85
Prognostic Value of Body Mass Index on Short‐Term and Long‐Term Outcome after Resection of Esophageal Cancer
Grotenhuis, B. A., Wijnhoven, B. P. L., Hötte, G. J., van der Stok, E. P., Tilanus, H. W., & van Lanschot, J. J. B. (2010) · World Journal of Surgery · doi:10.1007/s00268-010-0697-8 · Cited by 84
Quality Assessment in Surgery
Dindo, D. R., Hahnloser, D., & Clavien, P. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181d0d211 · Cited by 84
Preventing surgical site infections after bariatric surgery: value of perioperative antibiotic regimens
Chopra, T., Zhao, J., Alangaden, G. J., Wood, M. H., & Kaye, K. S. (2010) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/erp.10.26 · Cited by 83
Perioperative management of the obese surgical patient
Lang, L., Parekh, K. N., Tsui, B., & Maze, M. (2017) · British Medical Bulletin · doi:10.1093/bmb/ldx041 · Cited by 91
Obesity and Laparoscopic Colectomy
Mustain, W. C., Davenport, D. L., Hourigan, J. S., & Vargas, H. D. (2012) · Diseases of the Colon & Rectum · doi:10.1097/dcr.0b013e31823dfb17 · Cited by 82
Multicentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery
Collaborative, S., Drake, T. M., Nepogodiev, D., Chapman, S. J., Glasbey, J. C., Khatri, C., Kong, C. Y., Claireaux, H. A., Bath, M., Mohan, M., et al. (2016) · British journal of surgery · doi:10.1002/bjs.10203 · Cited by 80
Safety of Liver Resections in Obese and Overweight Patients
Balzan, S. M. P., Nagarajan, G., Farges, O., Galleano, C. Z., Dokmak, S., Paugam‐Burtz, C., & Belghiti, J. (2010) · World Journal of Surgery · doi:10.1007/s00268-010-0756-1 · Cited by 78
Obesity Increases Wound Complications in Rectal Cancer Surgery
Balentine, C. J., Wilks, J. A., Robinson, C. N., Marshall, C. L., Anaya, D., Albo, D., & Berger, D. H. (2010) · Journal of Surgical Research · doi:10.1016/j.jss.2010.03.012 · Cited by 76
Robotic approach mitigates perioperative morbidity in obese patients following pancreaticoduodenectomy
Girgis, M. D., Zenati, M. S., Steve, J., Bartlett, D. L., Zureikat, A. H., Zeh, H. J., & Hogg, M. E. (2016) · HPB · doi:10.1016/j.hpb.2016.11.008 · Cited by 75
Lifestyle and 30-day complications to surgery for colorectal cancer
Nickelsen, T. N., Jørgensen, T., & Kronborg, O. (2005) · Acta Oncologica · doi:10.1080/02841860510029707 · Cited by 77
Analysis of Impact of Body Mass Index on Outcomes of Laparoscopic Renal Surgery
Gong, E. M.-L., Orvieto, M. A., Lyon, M. B., Lucioni, A., Gerber, G. S., & Shalhav, A. L. (2007) · Urology · doi:10.1016/j.urology.2006.09.020 · Cited by 75
Hypocaloric feeding of obese patients in the intensive care unit
Dickerson, R. (2005) · Current opinion in clinical nutrition and metabolic care · doi:10.1097/00075197-200503000-00014 · Cited by 76
Effect of Obesity on Technical Feasibility and Postoperative Outcomes of Laparoscopy-Assisted Distal Gastrectomy—Comparison with Open Distal Gastrectomy
Yamada, H., Kojima, K., Inokuchi, M., Kawano, T., & Sugihara, K. (2007) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-007-0374-x · Cited by 73
The impact of obesity on surgical outcome after pancreaticoduodenectomy.
Noun, R. J., Riachy, E., Ghorra, C. S., Yazbeck, T., Tohmé, C., Abboud, B., Naderi, S., Chalhoub, V., Ayoub, E. N., & Yazbeck, P. H. (2008) · PubMed · Cited by 73
A systematic review and network meta-analysis of different surgical approaches for pancreaticoduodenectomy
Kamarajah, S. K., Bundred, J., Saint‐Marc, O., Jiao, L. R., Hilal, M. A., Manas, D., & White, S. A. (2019) · HPB · doi:10.1016/j.hpb.2019.09.016 · Cited by 74
Effects of subcutaneous drain for the prevention of incisional SSI in high-risk patients undergoing colorectal surgery
Fujii, T., Tabe, Y., Yajima, R., Yamaguchi, S., Tsutsumi, S., Asao, T., & Kuwano, H. (2011) · International Journal of Colorectal Disease · doi:10.1007/s00384-011-1228-2 · Cited by 72
“Obesity is a significant risk factor for wound infection after surgery [ 7 , 8]. Unfortunately, obesity is a risk factor that can be relatively difficult to mitigate in the perioperative period.”
Background
The Obese Colorectal Surgery Patient: Surgical Site Infection and Outcomes
Wahl, T. S., Patel, F. C., Goss, L. E., Chu, D. I., Grams, J. M., & Morris, M. S. (2018) · Diseases of the Colon & Rectum · doi:10.1097/dcr.0000000000001085 · Cited by 71
Obesity and kidney transplantation
Jindal, R. M., & Zawada, E. T. (2004) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2004.01.018 · Cited by 71
Obesity, Diabetes, and Smoking are Important Determinants of Resource Utilization in Liver Resection: A Multicenter Analysis of 1029 Patients
Gedaly, R., McHugh, P. P., Johnston, T. D., Jeon, H., Ranjan, D., & Davenport, D. L. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e31819a032d · Cited by 70
Anesthetic challenges in the obese patient
Domi, R., & Laho, H. (2012) · Journal of Anesthesia · doi:10.1007/s00540-012-1408-4 · Cited by 71
Association Between Obesity and Wound Infection Following Colorectal Surgery: Systematic Review and Meta-Analysis
Gurunathan, U., Ramsay, S., Mitric, G., Way, M., Wockner, L. F., & Myles, P. S. (2017) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-017-3494-y · Cited by 69
Effect of lifestyle, gender and age on collagen formation and degradation
Sørensen, L. T. (2006) · Hernia · doi:10.1007/s10029-006-0143-x · Cited by 68
Impact of Excess Body Weight on Postsurgical Complications
Plaßmeier, L., Hankir, M. K., & Seyfried, F. (2021) · Visceral Medicine · doi:10.1159/000517345 · Cited by 68
Simultaneous robotic kidney transplantation and bariatric surgery for morbidly obese patients with end-stage renal failure
Spaggiari, M., Cocco, P. D., Tulla, K. A., Kaylan, K. B., Masrur, M. A., Hassan, C., Alvarez, J. A., Benedetti, E., & Tzvetanov, I. G. (2020) · American Journal of Transplantation · doi:10.1111/ajt.16322 · Cited by 67
Obesity and nosocomial infections
Huttunen, R., Karppelin, M., & Syrjänen, J. (2013) · Journal of Hospital Infection · doi:10.1016/j.jhin.2013.06.012 · Cited by 67

Authors: Dindo, D., Muller, M. K., Weber, M., & Clavien, P.-A.
Affiliations: University Hospital Zurich (CH)
Corresponding author: Clavien, Pierre-Alain
ORCID: Weber, Markus
Clavien, Pierre-Alain
Venue: The Lancet
Publisher: Elsevier BV
Published: 2003-06
Volume: 361
Issue: 9374
Pages: 2032-2035
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(03)13640-9
OpenAlex: W2135384303
Cited by: 630
References: 32
Citations by year: 2026: 3 · 2025: 19 · 2024: 16 · 2023: 20 · 2022: 22 · 2021: 23 · 2020: 26 · 2019: 31 · 2018: 16 · 2017: 25 · 2016: 49 · 2015: 33 · 2014: 32 · 2013: 45 · 2012: 39
FWCI: 12.56
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Funders: Universität Zürich
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords: obesity, postoperative complications, postoperative morbidity, body mass index, wound infection, surgical risk factors, medical resource use, morbid obesity
MeSH terms: Adult, Analysis of Variance, Female, Humans, Length of Stay, Male, Middle Aged, Obesity, Postoperative Complications, Prospective Studies, Risk Factors, Surgical Wound Infection, Elective Surgical Procedures

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Obesity in general elective surgery

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