The impact of obesity on minimally invasive colorectal surge
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Operating on obese patients can increase case complexity and result in worse outcomes. Increasing BMI associated with increased conversion and operative time. In obese patients, robotics (Minimally invasive surgery-MIS) is associated with lower conversion and better outcomes.

Researchers described the incremental impact of BMI on morbidity and outcomes of colorectal operations and whether laparoscopic and robotic(MIS) approaches mitigate this morbidity differently.

A retrospective cohort of patients undergoing elective colorectal operations in SCOAP was created to examine the association of increasing BMI on surgical outcomes. Additionally, multivariable logistic regression models were constructed.

From 2011 to 2019, 22863 elective colorectal operations were performed at 42 hospitals. Patients had BMI≥30 in 7576 and BMI≥40 in 1180 of operations.

--After risk adjustment, BMI≥40 was associated with increased conversions, increased combined adverse events(CAE), and death.

--MIS approaches were each associated with lower CAE and death.

Conclusively, severe obesity is associated with increased conversion rates and worse short-term outcomes after colorectal surgery, though this trend is partially mitigated with a minimally invasive approach. These findings support the broad application of MIS for colorectal operations in obese patients.

The American Journal of Surgery
Source: https://doi.org/10.1016/j.amjsurg.2021.03.019
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