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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adenomatous polyps are common and factors that increase risk include race, gender, smoking, and obesity. This author summarizes the evidence supporting increased risk with these factors and describes how epidemiological data may be used to tailor screening programs.
Clin Colon Rectal Surg 2008 Nov
PMID:Factors that increase risk of colon polyps. 2001 35

In this article, the incidence, mortality, and survival rates for colorectal cancer are reviewed, with attention paid to regional variations and changes over time. A concise overview of known risk factors associated with colorectal cancer is provided, including familial and hereditary factors, as well as environmental lifestyle-related risk factors such as physical inactivity, obesity, smoking, and alcohol consumption.
Clin Colon Rectal Surg 2009 Nov
PMID:Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. 2103 9

Obesity has progressed in a few decades from a public health footnote in developed countries to a top-priority international issue. Because obesity implies increased morbidity and mortality from chronic, debilitating disorders, it is a major burden on individuals and health systems in both developing and developed countries. Obesity is a complex disorder unequally affecting all age groups and socioeconomic classes. Of special concern is increasing childhood obesity. This review presents the extent of the obesity epidemic and its impact worldwide by way of introduction to a discussion of colon and rectal surgery in the obese patient.
Clin Colon Rectal Surg 2011 Dec
PMID:Obesity epidemiology. 2320 35

Obesity is a medical epidemic with an enormous impact on disease prevalence and health care utilization. In the preoperative period, an awareness of medical issues associated with obesity is an important part of the planning for surgical procedures. The authors highlight the diagnostic and treatment options for medical conditions commonly affecting the obese patient including diabetes, hypertension, coronary artery disease, and deep venous thrombosis.
Clin Colon Rectal Surg 2011 Dec
PMID:Medical complications of obesity and optimization of the obese patient for colorectal surgery. 2320 36

The obese patient presents many challenges to both anesthesiologist and surgeon. A good understanding of the pathophysiologic effects of obesity and its anesthetic implications in the surgical setting is critical. The anesthesiologist must recognize increased risks and comorbidities inherent to the obese patient and manage accordingly, optimizing multisystem function in the perioperative period that leads to successful outcomes. Addressed from an organ systems approach, the purpose of this review is to provide surgical specialists with an overview of the anesthetic considerations of obesity. Minimally invasive surgery for the obese patient affords improved analgesia, postoperative pulmonary function, and shorter recovery times at the expense of a more challenging intraoperative anesthetic course. The physiologic effects of laparoscopy are discussed in detail. Although laparoscopy's physiologic effects on various organ systems are well recognized, techniques provide means for compensation and reversing such effects, thereby preserving good patient outcomes.
Clin Colon Rectal Surg 2011 Dec
PMID:Anesthetic implications of obesity in the surgical patient. 2320 37

Obesity is a risk factor for colorectal cancer based on its molecular and metabolic effects on insulin and IGF-1, leptin, adipocytokines, and sex hormones. Obese men have a higher risk of colorectal cancer compared with normal weight men, but the association between obesity and rectal cancer is weaker than with colon cancer. There is a weaker association between obesity and colon cancer in women than in men, and no appreciable association between obesity and rectal cancer in women. Although obesity does not seem to have an effect on the number of lymph nodes harvested with resection, obesity does seem to be associated with more-aggressive colorectal cancers in a handful of studies. Survival and local recurrence studies are contradictory with no conclusive evidence that obesity predisposes to worse overall survival or increased recurrence in colon and rectal cancers. The literature is not definitive as far as overall morbidity and mortality rates in the obese are concerned, though obese rectal cancer patients seem to incur proportionally more morbidity and mortality. Preexisting steatosis or steatohepatitis in obese colorectal cancer patients or chemotherapy-induced liver dysfunction may lead to an increased mortality in obese patients with colorectal liver metastases. Diabetes may cause poorer response to neoadjuvant therapy in rectal cancer and contribute to higher mortality and recurrence in colon cancer.
Clin Colon Rectal Surg 2011 Dec
PMID:Obesity and colorectal cancer. 2320 38

Obesity is becoming increasingly more common among patients with inflammatory bowel disease. In this review, we will explore the epidemiological trends of inflammatory bowel disease, the complex interplay between the proinflammatory state of obesity and inflammatory bowel disease, outcomes of surgery for inflammatory bowel disease in obese as compared with non-obese patients, and technical concerns pertaining to restorative proctocolectomy and ileoanal pouch reservoir, stoma creation and laparoscopic surgery for inflammatory bowel disease in obese patients.
Clin Colon Rectal Surg 2011 Dec
PMID:Inflammatory bowel disease in the obese patient. 2320 39

Diverticular disease is common in the Western world and is a considerable source of morbidity. Many have proposed an association between diverticular disease, its complications, and obesity. We examine this question through a review of the available literature. While it is likely that an association between diverticular disease and obesity exists, there is no evidence suggesting that obese patients should be managed any differently from the non-obese.
Clin Colon Rectal Surg 2011 Dec
PMID:Diverticular disease and the obese patient. 2320 40

It is well recognized that obesity contributes to multiple co-morbidities, and it would seem intuitive that obese patients experience an increase in post-operative complications after colorectal surgery. Overall, the data examining postoperative morbidity and mortality in the obese colorectal patient is inconsistent. Studies have shown a trend for obese patients have a higher post-operative risk of pulmonary embolism, atelectasis, cardiac complications, and thromboembolic disease. However, even with multiple large trials concluding this, there are also many studies showing no difference. The literature has shown that using laparoscopic techniques is safe and feasible, but there is a higher rate of conversion to open, and longer operative times. In addition, obese patients might have a higher leak rate for distal anastomosis as compared with normal weight patients. These patients also have a higher post-operative rate of stomal complications and fascial dehiscense. In reviewing the literature, at best, the complication rate in obese patients is the same as non-obese patients after colorectal surgery, but there are significant trends that suggest a negative effect of obesity after colorectal surgery.
Clin Colon Rectal Surg 2011 Dec
PMID:Complications following colon rectal surgery in the obese patient. 2320 43

Obesity affects over 30% of the United States population. Over the past 10 years, there has been increased recognition of the prevalence of obesity and its contribution to worse outcomes among medical and surgical patients. In particular, obesity has been validated as a risk factor for surgical site infection (SSI) among patients undergoing major abdominal surgery with some reports demonstrating an increased risk of SSI as high as sixty percent (60%) among obese patients. For patients undergoing elective colon and rectal surgery, a higher incidence of SSI (up to 45%) has been reported in comparison to outcomes of other surgical procedures. Obesity, as well as numerous other variables, have been implicated as a potential source for this increased incidence. Although the pathophysiology of obesity-related SSI has been suggested (decreased wound oxygen tension, impaired tissue antibiotic penetration, altered immune function, etc.), the true effect of obesity has not been clearly described. The purpose of this review is to examine the growing epidemic of obesity and its specific impact on SSI for both general and colorectal surgical patients. The proposed mechanisms for why obesity increases the risk of SSI will be briefly discussed, as well.
Clin Colon Rectal Surg 2011 Dec
PMID:Impact of obesity on surgical site infection in colon and rectal surgery. 2320 44


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