Impact of Increased Body Mass Index on Laparoscopic Surgery for Rectal Cancer

Abstract

Background: Laparoscopy was initially considered to be a risky procedure for rectal cancer patients, especially patients with an increased body weight. The literature is scarce regarding the effects of obesity on laparoscopic rectal surgery. The aim of the current study was to analyze the effect of an increased body mass index (BMI) on outcome of laparoscopic surgery for rectal cancer. Methods: Patients who underwent laparoscopic rectal resection were allocated to one of three groups according to their BMI: normal weight (BMI < 25), overweight (25 ≤ BMI < 30) and obese (BMI ≧ 30). These three groups were compared with each other in terms of patient demographics, postoperative hospital stay, postoperative complications and histopathological data. Results: There were 100 patients operated on for rectal cancer. The median BMI of the patients was 27 (range 18.5–40) kg/m², and 43, 43 and 14 patients were classified as normal weight, overweight and obese, respectively. The conversion rate was 4.7% in the overweight group and 0% in the other groups. The proportion of complications and oncological outcomes between the groups showed no significant difference (p > 0.05). Conclusions: Apparently, increased BMI is not a contraindication for laparoscopic rectal surgery.

Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis

“…Of these studies, 12 were excluded for various reasons: 3 used other variable definitions of obesity [2,12,13]; 5 compared outcomes in tertiles or quartiles of BMI [14][15][16][17][18]; 1 evaluated the clinical outcomes of patients with morbidly obese [19]; and 2 were review [1,20]. In total, eight observational studies published between 2002 and 2009 matched the inclusion criteria and were therefore included [4-9, 21, 22].…”

What Have We Gained by Performing Robotic Rectal Resection? Evaluation of 64 Consecutive Patients Who Underwent Laparoscopic or Robotic Low Anterior Resection for Rectal Adenocarcinoma

“…[2][3][4][5] Body mass index, previous surgery, deep and narrow pelvis, neoadjuvant chemoradiotherapy (NCRT), and the experience of the surgeon have an impact on the outcomes of the laparoscopic rectal cancer surgery. 6,7 Robotic surgery is thought to help overcome the limitations of laparoscopy for rectal resection in patients with cancer, but conducting randomized studies with high patient numbers on this topic is not possible currently even at high-volume centers specialized in colorectal surgery because of high costs of the robotic equipment and inexperience of surgeons on robotic rectal procedures. Since the publication of our outcomes on robotic rectal resection, 8 there have been a few comparative studies published comparing laparoscopic and robotic rectal surgery.…”

Robotic Surgery for Rectal Cancer: Initial Experience from 30 Consecutive Patients

“…2,4 Oncological radicality of the robotic rectal resection was similar to laparoscopic intervention in our series for harvested lymph nodes and the quality of mesorectal excision. 7 We performed complete TME for all of the patients with rectal cancer in the mid and lower rectum, with robotics. The robotic system, with the help of the 3D view, may be particularly beneficial when performing TME and dissecting the pelvis in NCRT receiving patients by reducing pelvic nerve injuries which LAR Low anterior resection, APR abdominoperineal resection, TME total mesorectal excision, PME partial mesorectal excision a Values are expressed as median (range) cause erectile and urinary dysfunctions.…”

“…14,17,21 In our series, the operative time was longer compared to that of our laparoscopic TME series. 7 Probably, the operative time would be shorter with increased experience.…”

“…6 We have been performing laparoscopic surgery for rectal cancer since 2003. 7 In January 2010, we considered the possibility of obtaining better results in rectal cancer surgery using robotics. Since then, we have treated 30 rectal cancer patients by using robotics.…”