title: Effect of BMI on Short-Term Outcomes with Robotic-Assisted Laparoscopic Surgery: a Case-Matched Study.
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/m(2)) and non-obese cohorts (BMI < 30 kg/m(2)), 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.
authors.affiliation: Colorectal Surgical Associates LLP LTD, Houston, TX, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Keller
authors.affiliation: Colorectal Surgical Associates LLP LTD, Houston, TX, USA.
authors.forename: Nisreen
authors.initials: N
authors.lastname: Madhoun
authors.affiliation: Colorectal Surgical Associates LLP LTD, Houston, TX, USA.
authors.forename: Juan Ramon
authors.initials: JR
authors.lastname: Flores-Gonzalez
authors.affiliation: Colorectal Surgical Associates LLP LTD, Houston, TX, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ibarra
authors.affiliation: Colorectal Surgical Associates LLP LTD, Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Reena
authors.initials: R
authors.lastname: Tahilramani
authors.affiliation: Division of Colon and Rectal Surgery, Colorectal Surgical Associates LLP LTD, Houston Methodist Hospital, Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, 6560 Fannin, Suite 1404, Houston, TX, 77030, USA. ehaasmd@houstoncolon.com.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Haas
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003108:Colonic Diseases / Q000150:complications / Q000601:surgery*; D005260:Female; D006760:Hospitalization; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000601:surgery; D061646:Operative Time; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
keywords: Colorectal surgery; Healthcare outcomes; Obesity; Robotics