Erschienen in:
01.03.2016 | 2015 SSAT Quick Shot Presentation
Effect of BMI on Short-Term Outcomes with Robotic-Assisted Laparoscopic Surgery: a Case-Matched Study
verfasst von:
Deborah S. Keller, Nisreen Madhoun, Juan Ramon Flores-Gonzalez, Sergio Ibarra, Reena Tahilramani, Eric M. Haas
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 3/2016
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Abstract
Background
Many benefits of minimally invasive surgery are lost in the obese, but robotic-assisted laparoscopic surgery (RALS) may offer advantages in this population. Our goal was to compare outcomes for RALS in obese and non-obese patients.
Methods
A prospective database was reviewed for colorectal resections using RALS. Patients were stratified into obese (BMI > 30 kg/m2) and non-obese cohorts (BMI < 30 kg/m2), then case-matched for comparability. The main outcome measures were operative time, conversion rate, length of stay and complication, readmission, and reoperation rates between groups.
Results
Forty-five patients were evaluated in each cohort. The BMI was significantly different (p < 0.01). All other demographics were well matched. There were no significant differences in operative time (p = 0.86), blood loss (p = 0.38), intraoperative complications (p = 0.54), or conversion rates (p = 0.91) across cohorts. Length of stay was comparable between groups (p = 0.45). Postoperatively, the complication (p = 0.87), readmission (p = 1.00), and reoperation rates (p = 0.95) were similar. There were no mortalities. For malignant cases (37.8 %), the lymph node yield (p = 0.48) and positive margins (p = 1.00) were similar and acceptable in both cohorts.
Conclusions
In our matched RALS series, perioperative and postoperative outcomes were similar between obese and non-obese patients undergoing colorectal surgery. RALS is a feasible option in the surgical setting of the obese patient. Further controlled studies are warranted to explore the full benefits.