A. Salem1, M. Thau2, K. Meredith1 1University Of Wisconsin,Section Of Surgical Oncology – Division Of General Surgery – The University Of Wisconsin School Of Medicine And Public Health,Madison, WI, USA 2University Of South Florida College Of Medicine,Tampa, FL, USA
Introduction: The impact of body weight on outcomes after robotic-assisted esophageal surgery for cancer has not been studied. We thus examined short-term operative outcomes in patients according to their body mass index (BMI) following robotic-assisted Ivor-Lewis esophagogastrostomy (RAIL) at a high-volume tertiary-care referral cancer center and evaluated the safety of robotic surgery in patients with an elevated BMI.
Methods: A retrospective review of all patients who underwent RAIL for pathologically confirmed distal esophageal cancer was conducted. Patient demographics, clinicopathologic data, and operative outcomes were collected. Current guidelines from the US Centers for Disease Control and Prevention and from the World Health Organization define underweight BMI range as below 18.5 kg/m². Normal range is defined as a BMI range of 18.5 to 24.9 kg/m². Overweight is defined as a BMI range of 25.0 to 29.9 kg/m² and obesity is defined as a BMI of 30 kg/m² and above. Statistics were calculated using Wilcoxon Rank-Sum and Spearman Coefficient tests with a p-value of 0.05 for significance.
Results:134 patients (106 men, 28 women) with an average age of 66 years were included. The majority of patients, 76% (N=102) received neoadjuvant therapy. When stratified by BMI, five patients were underweight, twenty-nine were normal weight, fifty-eight were overweight and forty-two were obese. All patients had R0 resection. Median operating room (OR) time was 421 minutes and median estimated blood loss was 160 cc. BMI significantly correlated with longer OR time (coefficient= 0.23; p=0.01) and higher EBL (coefficient=0.17; p=0.05).
Conclusion:This retrospective study shows that patients with distal esophageal cancer and an elevated BMI undergoing RAIL have increased operative times and EBL during the procedure.