Erin Worden, MD, Lala Hussain, MSc, Hamza Guend, MD. Good Samaritan Hospital
Background: Robotic-assisted surgery offers the advantages of instrumentation with added degrees of freedom, 3-dimensional surgeon controlled camera, and stable retraction. We hypothesize that such advantages may reduce the rate of conversion to open surgery in obese patients. The primary aim of our study was to determine if obesity increases the rate of conversion in patients undergoing robotic colorectal resection.
Methods: This study was a retrospective review of a prospectively collected database of 97 patients at a community-teaching hospital who underwent robotic colorectal resection between 2015-2018. The patients were divided into two groups, control (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). Patient demographics, perioperative variables, histopathologic data, post-operative complications, and conversion rates were collected and compared. The primary outcome was conversion rate. Major complications were defined as leak, intra-abdominal abscess, pneumonia, cardiac complications, re-operation, DVT, and compartment syndrome. Minor complications were defined as ileus, urinary tract infection, surgical site infection, and acute kidney injury.
Results: There were 47 patients in the obesity group (mean 35.6 kg/m2) and 50 patients in the control group (mean 25.1 kg/m2). There was no significant difference in regards to age, sex, ASA class (p= 0.353), or pathologic data. Leak rate was 10% in BMI <30 and 8.5% in BMI >30. The overall conversion rate was 6.2%. The rate of conversion was not significantly different between the two groups (10% vs 2.1%; p=0.205). There was no significant difference in post-operative major complications (p= 0.417) and minor complications (p= 0.805). There was a significant difference in radial margin (p=0.046), but no difference in distal margins (p=1).
Conclusion: Obesity does not impact conversion rate or post-operative complications in patients undergoing robotic-colorectal surgery, but there was a significant difference in circumferential margins.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95941
Program Number: P358
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster