Is obesity a factor of surgical difficulty in transanal endoscopic surgery?

Am J Surg. 2020 Sep;220(3):687-692. doi: 10.1016/j.amjsurg.2020.01.027. Epub 2020 Jan 20.

Abstract

Background: The aim of this study is to assess the feasibility of transanal endoscopic surgery (TES) in obese patients.

Methods: Observational descriptive study evaluating the feasibility of TES in obese rectal tumors between June 2004 and January 2019. Patients were assigned to two groups: body mass index (BMI) < 30 kg/m2 and BMI ≥30 kg/m2, the latter defined as obese.

Results: From 775 patients, 681 were enrolled in the study, 145 (21.3%) of them obese. No statistically significant differences between groups were found with respect to overall morbidity (27, 18.6%).The obese patients presented trends towards shorter mean surgical time (65 min, IQR 48 min), less perforation in the peritoneal cavity (eight, 5.5%), and 133 (91.7%) presented a lower rate of lesion fragmentation.

Conclusion: There were no significant differences in postoperative outcomes in obese patients (BMI ≥30 kg/m2). TES in those obese patients does not represent a factor of surgical difficulty.

Keywords: Body mass index; Minimally invasive surgery; Obesity; Rectal adenomas; TEM; TEO; Transanal endoscopic microsurgery.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications*
  • Rectal Neoplasms / complications*
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Risk Factors
  • Transanal Endoscopic Surgery*