Abstract:
Objective To investigate the effect of visceral obesity on the short-term curative effect of Da Vinci robotic-assisted radical resection for rectal cancers.
Methods Clinical and pathological data of patients with rectal cancer undergoing Da Vinci robotic-assisted surgery, admitted to People's Hospital of Zhengzhou University and Cancer Hospital of Zhengzhou University from November 2019 to June 2022 were retrospectively analyzed. Visceral fat area (VFA) ≥100 cm2 was used as the standard to define visceral obesity. Patients were categorized into visceral and non-visceral obesity groups. The short-term efficacy of the two groups was evaluated, and the influencing factors of postoperative complications were analyzed using univariate and multivariate Logistic regression.
Results Among a total of 169 patients, 93 were included in the visceral obesity group and 76 in the non-visceral obesity group. There was no significant difference in the baseline data between the two groups (P>0.05). There was no conversion to laparotomy in the non-visceral obesity group, and the conversion rate was 1.1% (1/93) in the visceral obesity group. The second operation rate was 2.2% (2/93) in the visceral obesity group and 1.3% (1/76) in the non-visceral obesity group with no statistical difference between the two groups. There were no significant differences in the operation duration, intraoperative blood loss, number of lymph node dissections, and total postoperative complication rate between the two groups (P>0.05). Multivariate Logistic regression analysis revealed that an NRS≥3 independently contributed as a risk factor for postoperative complications (OR=3.190, 95%CI:1.240−8.210, P=0.016).
Conclusions An NRS≥3 is an independent risk factor for complications post-robotic radical rectal cancer surgery. The robotic surgical platform can overcome obesity-related limitations and is equally safe and effective for patients with visceral obesity presenting with rectal cancer.
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