Robot Assisted Low Anterior Resection for Obese Rectal Cancer Patients: A Single-center Analysis of Short-term...

This study evaluates the short-term safety and technical feasibility of robot-assisted low anterior resection (RALAR) for rectal cancer in obese patients (BMI ≥ 25 kg/m²) compared to non-obese patients.

A retrospective cohort study was conducted on patients undergoing RALAR for rectal cancer at Okayama University Hospital (September 2020-January 2025). Patients were divided into obese (BMI ≥ 25 kg/m²) and non-obese (BMI < 25 kg/m²) groups. Patient characteristics, surgical data, and postoperative outcomes were analyzed. Statistical analysis was performed using appropriate tests (Student's t-test, Mann-Whitney U test) with a significance level of p < 0.05.

The study included 27 obese and 49 non-obese patients. The obese group had a significantly higher median BMI (28.1 vs. 21.6 kg/m², p < 0.01) and a higher proportion of patients with ASA classification ≥ 2 (81.5% vs. 57.1%, p = 0.03). There were no significant differences in operative time, console time, estimated blood loss, or conversion rate to open surgery. Postoperative complication rates were similar between groups (p=0.13). The incidence of severe complications (Clavien-Dindo grade III or higher) and anastomotic leakage were also not significantly different. Postoperative length of stay was comparable.

RALAR for obese rectal cancer patients is feasible, despite trends toward increased technical difficulty (more staple firings, longer operative times, higher blood loss, complications). No conversions occurred, and hospital stays were comparable.