Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?

E. Duchalais, N. Machairas, S. R. Kelley, R. G. Landmann, A. Merchea, D. T. Colibaseanu, K. L. Mathis, Eric Dozois, David Larson

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Obesity has been identified as a risk factor for both conversion and severe postoperative morbidity in patients undergoing laparoscopic rectal resection. Robotic-assisted surgery (RAS) is proposed to overcome some of the technical limitations associated with laparoscopic surgery for rectal cancer. The aim of our study was to determine if obesity remains a risk factor for severe morbidity in patients undergoing robotic-assisted rectal resection. Patients: This study was a retrospective review of a prospective database. A total of 183 patients undergoing restorative RAS for rectal cancer between 2007 and 2016 were divided into 2 groups: control (BMI < 30 kg/m2; n = 125) and obese (BMI ≥ 30 kg/m2; n = 58). Clinicopathologic data, 30-day postoperative morbidity, and perioperative outcomes were compared between groups. The main outcome was severe postoperative morbidity defined as any complication graded Clavien-Dindo ≥ 3. Results: Control and obese groups had similar clinicopathologic characteristics. Severe complications were observed in 9 (7%) and 4 (7%) patients, respectively (p > 0.99). Obesity did not impact conversion, anastomotic leak rate, length of stay, or readmission but was significantly associated with increased postoperative morbidity (29 vs. 45%; p = 0.04) and especially more postoperative ileus (11 vs. 26%; p = 0.01). Obesity and male gender were the two independent risk factors for postoperative overall morbidity (OR 1.97; 95% CI 1.02–3.94; p = 0.04 and OR 2.23; 95% CI 1.10–4.76; p = 0.03, respectively). Conclusion: ‎Obesity did not impact severe morbidity or conversion rate following RAS for rectal cancer but remained a risk factor for overall morbidity and especially postoperative ileus.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalSurgical Endoscopy and Other Interventional Techniques
DOIs
StateAccepted/In press - Jul 9 2018

Fingerprint

Robotics
Rectal Neoplasms
Obesity
Morbidity
Ileus
Anastomotic Leak
Laparoscopy
Length of Stay
Databases
Control Groups

Keywords

  • Obesity
  • Postoperative ileus
  • Postoperative morbidity
  • Rectal cancer
  • Rectal resection
  • Robotic-assisted surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer? / Duchalais, E.; Machairas, N.; Kelley, S. R.; Landmann, R. G.; Merchea, A.; Colibaseanu, D. T.; Mathis, K. L.; Dozois, Eric; Larson, David.

In: Surgical Endoscopy and Other Interventional Techniques, 09.07.2018, p. 1-7.

Research output: Contribution to journalArticle

Duchalais, E. ; Machairas, N. ; Kelley, S. R. ; Landmann, R. G. ; Merchea, A. ; Colibaseanu, D. T. ; Mathis, K. L. ; Dozois, Eric ; Larson, David. / Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?. In: Surgical Endoscopy and Other Interventional Techniques. 2018 ; pp. 1-7.
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abstract = "Introduction: Obesity has been identified as a risk factor for both conversion and severe postoperative morbidity in patients undergoing laparoscopic rectal resection. Robotic-assisted surgery (RAS) is proposed to overcome some of the technical limitations associated with laparoscopic surgery for rectal cancer. The aim of our study was to determine if obesity remains a risk factor for severe morbidity in patients undergoing robotic-assisted rectal resection. Patients: This study was a retrospective review of a prospective database. A total of 183 patients undergoing restorative RAS for rectal cancer between 2007 and 2016 were divided into 2 groups: control (BMI < 30 kg/m2; n = 125) and obese (BMI ≥ 30 kg/m2; n = 58). Clinicopathologic data, 30-day postoperative morbidity, and perioperative outcomes were compared between groups. The main outcome was severe postoperative morbidity defined as any complication graded Clavien-Dindo ≥ 3. Results: Control and obese groups had similar clinicopathologic characteristics. Severe complications were observed in 9 (7{\%}) and 4 (7{\%}) patients, respectively (p > 0.99). Obesity did not impact conversion, anastomotic leak rate, length of stay, or readmission but was significantly associated with increased postoperative morbidity (29 vs. 45{\%}; p = 0.04) and especially more postoperative ileus (11 vs. 26{\%}; p = 0.01). Obesity and male gender were the two independent risk factors for postoperative overall morbidity (OR 1.97; 95{\%} CI 1.02–3.94; p = 0.04 and OR 2.23; 95{\%} CI 1.10–4.76; p = 0.03, respectively). Conclusion: ‎Obesity did not impact severe morbidity or conversion rate following RAS for rectal cancer but remained a risk factor for overall morbidity and especially postoperative ileus.",
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T1 - Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?

AU - Duchalais, E.

AU - Machairas, N.

AU - Kelley, S. R.

AU - Landmann, R. G.

AU - Merchea, A.

AU - Colibaseanu, D. T.

AU - Mathis, K. L.

AU - Dozois, Eric

AU - Larson, David

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N2 - Introduction: Obesity has been identified as a risk factor for both conversion and severe postoperative morbidity in patients undergoing laparoscopic rectal resection. Robotic-assisted surgery (RAS) is proposed to overcome some of the technical limitations associated with laparoscopic surgery for rectal cancer. The aim of our study was to determine if obesity remains a risk factor for severe morbidity in patients undergoing robotic-assisted rectal resection. Patients: This study was a retrospective review of a prospective database. A total of 183 patients undergoing restorative RAS for rectal cancer between 2007 and 2016 were divided into 2 groups: control (BMI < 30 kg/m2; n = 125) and obese (BMI ≥ 30 kg/m2; n = 58). Clinicopathologic data, 30-day postoperative morbidity, and perioperative outcomes were compared between groups. The main outcome was severe postoperative morbidity defined as any complication graded Clavien-Dindo ≥ 3. Results: Control and obese groups had similar clinicopathologic characteristics. Severe complications were observed in 9 (7%) and 4 (7%) patients, respectively (p > 0.99). Obesity did not impact conversion, anastomotic leak rate, length of stay, or readmission but was significantly associated with increased postoperative morbidity (29 vs. 45%; p = 0.04) and especially more postoperative ileus (11 vs. 26%; p = 0.01). Obesity and male gender were the two independent risk factors for postoperative overall morbidity (OR 1.97; 95% CI 1.02–3.94; p = 0.04 and OR 2.23; 95% CI 1.10–4.76; p = 0.03, respectively). Conclusion: ‎Obesity did not impact severe morbidity or conversion rate following RAS for rectal cancer but remained a risk factor for overall morbidity and especially postoperative ileus.

AB - Introduction: Obesity has been identified as a risk factor for both conversion and severe postoperative morbidity in patients undergoing laparoscopic rectal resection. Robotic-assisted surgery (RAS) is proposed to overcome some of the technical limitations associated with laparoscopic surgery for rectal cancer. The aim of our study was to determine if obesity remains a risk factor for severe morbidity in patients undergoing robotic-assisted rectal resection. Patients: This study was a retrospective review of a prospective database. A total of 183 patients undergoing restorative RAS for rectal cancer between 2007 and 2016 were divided into 2 groups: control (BMI < 30 kg/m2; n = 125) and obese (BMI ≥ 30 kg/m2; n = 58). Clinicopathologic data, 30-day postoperative morbidity, and perioperative outcomes were compared between groups. The main outcome was severe postoperative morbidity defined as any complication graded Clavien-Dindo ≥ 3. Results: Control and obese groups had similar clinicopathologic characteristics. Severe complications were observed in 9 (7%) and 4 (7%) patients, respectively (p > 0.99). Obesity did not impact conversion, anastomotic leak rate, length of stay, or readmission but was significantly associated with increased postoperative morbidity (29 vs. 45%; p = 0.04) and especially more postoperative ileus (11 vs. 26%; p = 0.01). Obesity and male gender were the two independent risk factors for postoperative overall morbidity (OR 1.97; 95% CI 1.02–3.94; p = 0.04 and OR 2.23; 95% CI 1.10–4.76; p = 0.03, respectively). Conclusion: ‎Obesity did not impact severe morbidity or conversion rate following RAS for rectal cancer but remained a risk factor for overall morbidity and especially postoperative ileus.

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KW - Postoperative morbidity

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KW - Rectal resection

KW - Robotic-assisted surgery

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