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Session: ePoster: Colon and Colorectal Cancer 18 (Tue8)

EP929 - Comparison of surgical outcomes of robotic complete mesocolic excision for right-sided colon cancer in obese versus non-obese patients

Tuesday, May 13, 2025
8:32 AM – 8:37 AM PT

    ePoster Presenter(s)

  • Teppei Miyakawa, MD, MPH

    Postdoctoral fellow
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    Houston, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Kentaro Ochiai, MD

    Visiting scientist
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    Disclosure information not submitted.

  • MG

    Montserrat Guraieb-Trueba, MD

    Assistant Professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • RB

    Ramy S Behman, MD

    Assistant professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    Disclosure information not submitted.

  • Abhineet Uppal, MD

    Assistant professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    Disclosure information not submitted.

  • Craig A. Messick, M.D., FACS, FASCRS

    Associate professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    Disclosure information not submitted.

  • Michael G. White, M.D., MSc.

    Assistant professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • BB

    Brian Keith Bednarski, M.D., MHEP, FACS

    Associate professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Y. Nancy You, MD, MHSc

    Professor
    University of Texas MD Anderson Cancer Center

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Tsuyoshi Konishi, M.D., PhD.

    Associate professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • George J J. Chang, M.D., M.Sc., MHCM, FACS, FASCRS, FSSO (he/him/his)

    Chair Ad Interim and Professor
    Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Teppei Miyakawa, MD, MPH: This individual has no financial relationships with ineligible companies.
Montserrat Guraieb-Trueba, MD: This individual has no financial relationships with ineligible companies.
Michael G. White, M.D., MSc.: This individual has no financial relationships with ineligible companies.
Brian Keith Bednarski, M.D., MHEP, FACS: This individual has no financial relationships with ineligible companies.
Y. Nancy You, MD, MHSc: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: In the United States, obese patients comprise approximately 40% of the adult population. Complete mesocolic excision (CME) for right-sided colon cancer is a technically demanding procedure and a major concern of this approach is whether it can be performed safely in obese patients. The purpose of this study is to perform a contemporary evaluation of the perioperative safety and oncological outcomes of robotic CME for right-sided colon cancer in obese versus non-obese patients.

Methods/Interventions: A retrospective observational consecutive cohort study was performed of patients who underwent robotic CME for right-sided colon cancer between 2015 and 2023. Patients were identified from prospectively maintained database and divided into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups. Surgical outcomes included postoperative complications, conversion rate, operative time, blood loss, length of stay (LOS). Pathological outcomes included the number of lymph node harvest and margin status (distance to proximal, distal, and vascular margin and circumferential resection margin [CRM]). Survival outcomes included overall survival and recurrence free survival (RFS). Surgical and pathological outcomes of obese versus non-obese groups were compared using univariate analysis. Survival outcomes were analyzed using Kaplan-Meier method and log rank test.

Results/Outcomes: Of a total of 211 patients, 80 (37.9%) were obese. There were no baseline differences in age, sex, American Society of Anesthesiologists score, cancer site, neoadjuvant chemotherapy, histological grade, and pathological staging. The rate of any grade or grade III complications did not significantly differ between the obese and non-obese groups (any grade, 18.8% versus 12.2%, P = 0.24; grade III, 3.8% versus 1.5%, P = 0.30). Specifically, there were no cases of vascular injury in either group. There was no anastomotic leakage in either group. Conversion to open surgery occurred in 4 patients (5%) in the obese group and 1 patient (0.8%) in the non-obese group (P = 0.05). The median LOS was 3 days in both groups with no difference (P = 0.071). Operative time (290 versus 247 min, P = 0.0025) and blood loss (50 versus 30 mL, P = 0.025) were greater in the obese group than non-obese group. There was no cases of CRM positivity in either group and no significant differences between two groups in the lymph node harvest and distance to proximal, distal, and vascular margin. After a median follow-up period was 2.6 years there was no difference in RFS between the obese and non-obese groups (5-year RFS, 85.4% versus 82.5%, P = 0.67).

Conclusion/Discussion: Perioperative and oncological outcomes of robotic CME for right-sided colon cancers among obese patients were comparable to the outcomes among non-obese although obesity was associated with longer operative time and greater blood loss. Robotic CME for right-sided colon cancer in obese patients is technically and oncologically effective.