Security and Feasibility of Laparoscopic Rectal Cancer Resection in Morbidly Obese Patients

Background: Rectal resection for cancer can be technically challenging, especially in the obese patient. While some have investigated the impact of laparoscopic surgery on rectal cancer, no study looked at the subgroup of morbidly obese patients. Objectives: Our goal was to evaluate feasibility and safety of laparoscopic rectal resection for cancer in this population. Methods: All morbidly obese patients, defined as a body mass index (BMI) of 40 kg/m or greater, undergoing laparoscopic rectal cancer resection for primary cancer between January 2006 and July 2013, were identified using medical records in a single academic hospital center. Results: Thirteen patients underwent laparoscopic approach. The median BMI was 42.4 kg/m. There were 4 conversions (30%). Anastomotic leak occurred in 2 patients (15.4%). TME was complete in only 9 patients (69.2%), with 3 patients with incomplete TME being also in the conversion group. There was no mortality. There was no recurrence. Conclusions: This study suggests that laparoscopic rectal resection for cancer in morbidly obese patients is challenging and associated with a higher rate of conversion compared to patients with lower BMI. Mortality, morbidity and readmission rates are similar to the literature showing the same benefit for laparoscopic procedure.