Impact of Robotic Total Mesorectal Excision Upon Pathology Metrics in Overweight Males With Low Rectal Cancer: A Pooled Analysis of 836 Cases

Authors

Mahir Gachabayov, Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
Hanjoo Lee, Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrence, CA, USA.Follow
Agon Kajmolli, Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
Daniel M. Felsenreich, Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
Roberto Bergamaschi, Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA. rcmbergamaschi@gmail.com.Follow

Author Type(s)

Resident/Fellow, Faculty

DOI

10.1007/s13304-023-01733-y

Journal Title

Updates in Surgery

First Page

505

Last Page

512

Document Type

Article

Publication Date

4-1-2024

Department

Surgery

Abstract

The aim of this pooled analysis was to evaluate the impact of robotic total mesorectal excision (TME) on pathology metrics in Male Overweight patients with Low rectal cancer (MOL). This was a multicenter retrospective pooled analysis of data. Two groups were defined: MOL (Male, Overweight, Low rectal cancer) and non-MOL. Overweight was defined as BMI ≥ 25 kg/m. Low rectal cancer was defined as cancer within 6 cm from the anal verge. The primary endpoints of this study were histopathological metrics, namely circumferential resection margin (CRM) (mm), CRM involvement rate (%), and the quality of TME. Circumferential resection margin (CRM) was involved if < 1 mm. 836 (106 MOL and 730 non-MOL) patients that underwent robotic TME by six surgeons over 3 years were compared. No significant differences in demographics and perioperative variables were found, except for operating time, distal margin, and number of lymph nodes harvested. CRM involvement rate did not significantly differ (7.5% vs. 5.5%, p = 0.395). Mean CRM was statistically significantly narrower in MOL patients (6.6 vs. 7.7 mm, p = 0.04). Quality of TME did not differ. Distance of tumor from the anal verge was the only independent predictor of CRM involvement. Robotic TME may provide optimal pathology metrics in overweight males with low rectal cancer. Although CRM was a few millimeters narrower in MOL, the values were within the range of uninvolved margins making the difference statistically significant, but not clinically. Being MOL was not a risk factor for involvement of circumferential resection margin.

Recommended Citation

Gachabayov, M., Lee, H., Kajmolli, A., Felsenreich, D. M., & Bergamaschi, R. (2024). Impact of Robotic Total Mesorectal Excision Upon Pathology Metrics in Overweight Males With Low Rectal Cancer: A Pooled Analysis of 836 Cases. Updates in Surgery, 76 (2), 505-512. https://doi.org/10.1007/s13304-023-01733-y