ArticleDiseases of the colon and rectum2014
Effect of BMI on outcomes in proctectomy.
Article in Diseases of the colon and rectum, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- The effect of excess body weight on short-term outcomes following minimally invasive rectal cancer surgery: a systematic review and meta-analysis.Techniques in coloproctology · 2026Pooled it
- Influence of BMI on robotic rectal cancer surgery: a systematic review and meta-analysis.Journal of robotic surgery · 2025Pooled it
- Impact of obesity on morbidity and oncologic outcomes after total mesorectal excision for mid and low rectal cancer.Techniques in coloproctology · 2023Pooled it
- Outcome of rectal cancer surgery in obese and nonobese patients: a meta-analysis.World journal of surgical oncology · 2016Pooled it
- SAGES colorectal and metabolic bariatric surgery committee joint task force call to action for synchronized severe obesity and colorectal cancer management.Surgical endoscopy · 2026Review
- The Impact of Obesity on Operative Outcomes and Long-Term Oncological Outcomes Following Rectal Cancer Surgery: A Retrospective Single-Center Study.Journal of clinical medicine · 2026Article
- Impact of obesity on patients undergoing surgery for rectal cancer in Australia and New Zealand.International journal of colorectal disease · 2023Article
- Factors that make Bariatric Surgery Technically Challenging: A Survey of 370 Bariatric Surgeons.World journal of surgery · 2021Article
- Article
- What Makes Bariatric Operations Difficult-Results of a National Survey.Medicina (Kaunas, Lithuania) · 2019Article
- Influence of Body Mass Index on Long-Term Outcome in Patients with Rectal Cancer-A Single Centre Experience.Cancers · 2019Article
- The BMI Paradox and Robotic Assisted Partial Nephrectomy.Frontiers in surgery · 2019Article
- Prospective Validation of the Iowa Rectal Surgery Risk Calculator.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- Obesity as a surgical risk factor.Annals of gastroenterological surgery · 2018Review
- Is There Any Reason Not to Perform Standard Laparoscopic Total Mesorectal Excision?Clinics in colon and rectal surgery · 2017Review
- Impact of Body Mass Index on Early Postoperative and Long-Term Outcome after Rectal Cancer Surgery.Visceral medicine · 2017Article
- Differences in short-term outcomes among patients undergoing IPAA with or without preoperative radiation: a National Surgical Quality Improvement Program analysis.Diseases of the colon and rectum · 2014Article
- Development of an improved risk calculator for complications in proctectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2014Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe unique surgical challenges of proctectomy may be amplified in obese patients. We examined surgical outcomes of a large, diverse sample of obese patients undergoing proctectomy.
objectiveThe purpose of this work was to determine whether increased BMI is associated with increased complications in proctectomy.
designThis was a retrospective review. SETTINGS: The study uses the American College of Surgeons National Surgical Quality Improvement Program database (2010 and 2011). PATIENTS: Patients included were those undergoing nonemergent proctectomy, excluding rectal prolapse cases. Patients were grouped by BMI using the World Health Organization classifications of underweight (BMI <18.5); normal (18.5-24.9); overweight (25.0-29.9); and class I (30.0-34.9), class II (35.0-39.9), and class III (≥40.0) obesity.
main outcome measuresWe analyzed the effect of preoperative and intraoperative factors on 30-day outcomes. Continuous variables were compared with Wilcoxon rank-sum tests and proportions with the Fisher exact or χ tests. Logistic regression controlled for the effects of multiple risk factors.
resultsAmong 5570 patients, class I, II, and III obesity were significantly associated with higher rates of overall complications (44.0%, 50.8%, and 46.6% vs 38.1% for normal-weight patients; p < 0.05). Superficial wound infection was significantly higher in classes I, II, and III (11.6%, 17.8%, and 13.0% vs 8.0% for normal-weight patients; p < 0.05). Operative times for patients in all obesity classes were significantly longer than for normal-weight patients. On multivariate analysis, an obese BMI independently predicted complications; ORs (95% CIs) were 1.36 (1.14-1.62) for class I obesity, 1.99 (1.54-2.54) for class II, and 1.42 (1.02-1.96) for class III. LIMITATIONS: This study was a retrospective design with limited follow-up.
conclusionsClass I, II, and III obese patients were at significantly increased risk for morbidity compared with normal BMI patients. Class II obese patients had the highest rate of complications, a finding that deserves further investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.