Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?
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 rec...
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| Veröffentlicht in: | Surgical endoscopy 2018-12, Vol.32 (12), p.4886-4892 |
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| creator | Duchalais, E. Machairas, N. Kelley, S. R. Landmann, R. G. Merchea, A. Colibaseanu, D. T. Mathis, K. L. Dozois, E. J. Larson, D. W. |
| description | 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 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. |
| doi_str_mv | 10.1007/s00464-018-6247-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2067885717</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2067885717</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-d8d9c4f69fd2a9e55cbf4c3f4e49822bf3c50d192de05b8a61043f29730cab2f3</originalsourceid><addsrcrecordid>eNp10E2L1TAUgOEginMd_QFupODGTTQ5TZtkJTJ-woAbXcc0PRk6tE3NSZX7783ljgqCqyzynJPwMvZUipdSCP2KhFC94kIa3oPSXN1jB6la4ADS3GcHYVvBQVt1wR4R3YrKrewesguw1uiuhwP79jYhNWlAmsqxmZbNh9JsiUraMPsy_cAm7SWkpaqY5jn9nNabJqchlSlwTzRRwbGhPd9gPlaSm4yh-LkJfg2YXz9mD6KfCZ_cnZfs6_t3X64-8uvPHz5dvbnmQbWm8NGMNqjY2ziCt9h1YYgqtFGhsgZgiG3oxCgtjCi6wfheCtVGsLoVwQ8Q20v24rx3y-n7jlTcMlHAefYrpp0ciF4b02mpK33-D71Ne17r706qN1oqgKrkWYWciDJGt-Vp8fnopHCn_O6c39X87pTfqTrz7G7zPiw4_pn43bsCOAOqV2tN9vfp_2_9BZ6LkXw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2066871422</pqid></control><display><type>article</type><title>Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?</title><source>SpringerNature Journals</source><creator>Duchalais, E. ; Machairas, N. ; Kelley, S. R. ; Landmann, R. G. ; Merchea, A. ; Colibaseanu, D. T. ; Mathis, K. L. ; Dozois, E. J. ; Larson, D. W.</creator><creatorcontrib>Duchalais, E. ; Machairas, N. ; Kelley, S. R. ; Landmann, R. G. ; Merchea, A. ; Colibaseanu, D. T. ; Mathis, K. L. ; Dozois, E. J. ; Larson, D. W.</creatorcontrib><description>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/m
2
;
n
= 125) and obese (BMI ≥ 30 kg/m
2
;
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.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6247-4</identifier><identifier>PMID: 29987562</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Colorectal cancer ; Gastroenterology ; Gynecology ; Health risk assessment ; Hepatology ; Laparoscopy ; Medicine ; Medicine & Public Health ; Morbidity ; Obesity ; Postoperative period ; Proctology ; Robotic surgery ; Surgery</subject><ispartof>Surgical endoscopy, 2018-12, Vol.32 (12), p.4886-4892</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-d8d9c4f69fd2a9e55cbf4c3f4e49822bf3c50d192de05b8a61043f29730cab2f3</citedby><cites>FETCH-LOGICAL-c438t-d8d9c4f69fd2a9e55cbf4c3f4e49822bf3c50d192de05b8a61043f29730cab2f3</cites><orcidid>0000-0003-3654-2963</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6247-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6247-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27933,27934,41497,42566,51328</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29987562$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duchalais, E.</creatorcontrib><creatorcontrib>Machairas, N.</creatorcontrib><creatorcontrib>Kelley, S. R.</creatorcontrib><creatorcontrib>Landmann, R. G.</creatorcontrib><creatorcontrib>Merchea, A.</creatorcontrib><creatorcontrib>Colibaseanu, D. T.</creatorcontrib><creatorcontrib>Mathis, K. L.</creatorcontrib><creatorcontrib>Dozois, E. J.</creatorcontrib><creatorcontrib>Larson, D. W.</creatorcontrib><title>Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>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/m
2
;
n
= 125) and obese (BMI ≥ 30 kg/m
2
;
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.</description><subject>Abdominal Surgery</subject><subject>Colorectal cancer</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Hepatology</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Obesity</subject><subject>Postoperative period</subject><subject>Proctology</subject><subject>Robotic surgery</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp10E2L1TAUgOEginMd_QFupODGTTQ5TZtkJTJ-woAbXcc0PRk6tE3NSZX7783ljgqCqyzynJPwMvZUipdSCP2KhFC94kIa3oPSXN1jB6la4ADS3GcHYVvBQVt1wR4R3YrKrewesguw1uiuhwP79jYhNWlAmsqxmZbNh9JsiUraMPsy_cAm7SWkpaqY5jn9nNabJqchlSlwTzRRwbGhPd9gPlaSm4yh-LkJfg2YXz9mD6KfCZ_cnZfs6_t3X64-8uvPHz5dvbnmQbWm8NGMNqjY2ziCt9h1YYgqtFGhsgZgiG3oxCgtjCi6wfheCtVGsLoVwQ8Q20v24rx3y-n7jlTcMlHAefYrpp0ciF4b02mpK33-D71Ne17r706qN1oqgKrkWYWciDJGt-Vp8fnopHCn_O6c39X87pTfqTrz7G7zPiw4_pn43bsCOAOqV2tN9vfp_2_9BZ6LkXw</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Duchalais, E.</creator><creator>Machairas, N.</creator><creator>Kelley, S. R.</creator><creator>Landmann, R. G.</creator><creator>Merchea, A.</creator><creator>Colibaseanu, D. T.</creator><creator>Mathis, K. L.</creator><creator>Dozois, E. J.</creator><creator>Larson, D. W.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3654-2963</orcidid></search><sort><creationdate>20181201</creationdate><title>Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?</title><author>Duchalais, E. ; Machairas, N. ; Kelley, S. R. ; Landmann, R. G. ; Merchea, A. ; Colibaseanu, D. T. ; Mathis, K. L. ; Dozois, E. J. ; Larson, D. W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-d8d9c4f69fd2a9e55cbf4c3f4e49822bf3c50d192de05b8a61043f29730cab2f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Colorectal cancer</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Hepatology</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Obesity</topic><topic>Postoperative period</topic><topic>Proctology</topic><topic>Robotic surgery</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duchalais, E.</creatorcontrib><creatorcontrib>Machairas, N.</creatorcontrib><creatorcontrib>Kelley, S. R.</creatorcontrib><creatorcontrib>Landmann, R. G.</creatorcontrib><creatorcontrib>Merchea, A.</creatorcontrib><creatorcontrib>Colibaseanu, D. T.</creatorcontrib><creatorcontrib>Mathis, K. L.</creatorcontrib><creatorcontrib>Dozois, E. J.</creatorcontrib><creatorcontrib>Larson, D. W.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duchalais, E.</au><au>Machairas, N.</au><au>Kelley, S. R.</au><au>Landmann, R. G.</au><au>Merchea, A.</au><au>Colibaseanu, D. T.</au><au>Mathis, K. L.</au><au>Dozois, E. J.</au><au>Larson, D. W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer?</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>32</volume><issue>12</issue><spage>4886</spage><epage>4892</epage><pages>4886-4892</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><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/m
2
;
n
= 125) and obese (BMI ≥ 30 kg/m
2
;
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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29987562</pmid><doi>10.1007/s00464-018-6247-4</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3654-2963</orcidid></addata></record> |
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| issn | 0930-2794 1432-2218 |
| language | eng |
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| source | SpringerNature Journals |
| subjects | Abdominal Surgery Colorectal cancer Gastroenterology Gynecology Health risk assessment Hepatology Laparoscopy Medicine Medicine & Public Health Morbidity Obesity Postoperative period Proctology Robotic surgery Surgery |
| title | Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer? |
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