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

Q: What was the study’s primary goal regarding obese patients?

To evaluate the perioperative safety and oncological outcomes of robotic complete mesocolic excision (CME) for right-sided colon cancer in obese versus non-obese patients.

Q: How were patients categorized in the study?

Patients were divided into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups.

Q: What differences did obesity show in operative and clinical outcomes?

Obese patients had longer operative times and greater blood loss, while complication rates and conversion rates were not associated with a clearly worse safety profile.

Sep 22, 2026

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Robotic complete mesocolic excision (CME) for right-sided colon cancer raises concern about whether it can be performed safely in obese patients. This single-institution retrospective cohort study compared perioperative safety and oncological outcomes between obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) patients undergoing robotic CME from 2015–2023. Obesity showed longer operative times and increased blood loss, without higher complication rates or worse survival.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Methods

Patient identification and data collection

Conversion to open surgery and complications

Surgical Endoscopy (2026) 40:3873–3883 [https://doi.org/10.1007/s00464-026-12650-7](https://doi.org/10.1007/s00464-026-12650-7) and Other Interventional Techniques Comparison of surgical outcomes of robotic complete mesocolic excision for right‑sided colon cancer in obese versus non‑obese patients Teppei Miyakawa1 · Kentaro Ochiai1 · Montserrat Guraieb‑Trueba1 · Jaganmurugan Ramamurthy1 · Ramy Behman1 · Craig A. Messick1 · Sa Nguyen1 · Tsuyoshi Konishi1 · George J. Chang1 Received: 29 July 2025 / Accepted: 6 February 2026 / Published online: 25 February 2026 © The Author(s) 2026 Abstract Background A major concern of complete mesocolic excision (CME) for right-sided colon cancer is whether it can be performed safely in obese patients. The aim 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 This was a single-institution retrospective cohort study of patients who underwent robotic CME for right-sided colon cancer between 2015 and 2023. Patients were divided into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/ m2) groups. Perioperative complications, operative metrics, pathological results, overall survival (OS), and recurrence-free survival (RFS) were compared. Results Of 211 patients, 80 (37.9%) were obese. Complication rates did not differ significantly between obese and nonobese groups (any grade: 18.8% vs 12.2%, P = 0.24; grade III: 3.8% vs 1.5%, P = 0.30) . No vascular injuries occurred in either group. Conversion rates (5.0% vs 0.8%, P = 0.05) and length of stay were similar. Obese patients had longer operative times (289.5 vs 247 min, P = 0.003) and greater blood loss (50 vs 30 mL, P = 0.025). No cases had positive circumferential resection margins. Lymph node harvest (34.5 vs 34 nodes, P = 0.85) and margin status were comparable. During median follow-up of 2.6 years, 3-year RFS was similar between groups (89.1% vs 86.7%, P = 0.63), with no significant differences in OS (100% vs 95 .6%, P = 0. 13) . Conclusions Obesity was associated with longer operative times and increased blood loss but not with higher complication rates or worse survival outcomes. Robotic CME appears technically and oncologically feasible for both obese and non-obese patients with right-sided colon cancer. Keywords Robotic surgery · Complete mesocolic excision · Obesity · Colon cancer · Survival outcomes · Minimally invasive surgery Colon cancer affects approximately 1,148,000 new patients worldwide each year [1] . Standardized surgical approaches including complete mesocolic excision (CME) and complete D2 or D3 lymph node dissection are optimal oncologic approaches associated with better prognosis than conventional surgery [2–5] . These approaches require dissection along the superior mesenteric vein and are technically * George J. Chang [gchang@mdanderson.org](gchang@mdanderson.org) 1 Division of Surgery, Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.5022, Unit 1484, Houston, TX 77030-4008, USA demanding procedures, especially in obese patients because abundant visceral fat makes it difficult to identify vascular and landmark anatomic structures. A major concern of this approach is whether it can be performed safely in obese patients. In the United States, where obese patients comprise approximately 40% of the adult population [6], CME for right-sided colon cancer is not a standard approach due to concerns for risk of vascular injury and lack of familiarity with vascular anatomy and its variation. The robotic platform offers several advantages that may facilitate technically demanding minimally invasive surgeries like CME for right-sided colon cancer or surgery in obese patients [7, 8] . It has been suggested that robotic surgery for obese patients with colorectal cancer had more favorable short-

FAQs

What was the study’s primary goal regarding obese patients?

To evaluate the perioperative safety and oncological outcomes of robotic complete mesocolic excision (CME) for right-sided colon cancer in obese versus non-obese patients.

How were patients categorized in the study?

Patients were divided into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups.

What differences did obesity show in operative and clinical outcomes?

Obese patients had longer operative times and greater blood loss, while complication rates and conversion rates were not associated with a clearly worse safety profile.

Sep 22, 2026

Upload by Rizky