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Does the visceral fat area impact the histopathology specimen metrics after total mesorectal excision for distal rectal cancer?

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Abstract

Background

The aim of this study was to evaluate whether the visceral fat area (VFA) has an impact on the histopathology specimen metrics of male patients undergoing robotic total mesorectal resection (rTME) for distal rectal cancer.

Methods

Prospectively collected data of patients undergoing rTME for resectable rectal cancer by five surgeons during a period of three years were extracted from the REgistry of Robotic SURgery for RECTal cancer (RESURRECT). VFA was measured in all patients at preoperative computed tomography. Distal rectal cancer was defined as <6cm from the anal verge. The histopathology metrics included circumferential resection margin (CRM) (in mm) and its involvement rate (if <1mm), distal resection margin (DRM), and quality of TME (complete, nearly-complete, incomplete).

Results

Of 839 patients who underwent rTME, 500 with distal rectal cancer were included. One hundred and six (21.2%) males with VFA>100cm2 were compared to 394 (78.8%) males or females with VFA≤100cm2. The mean CRM of males with VFA>100cm2 was not significantly different from its counterpart (6.6 ± 4.8 mm versus 7.1 ± 9.5mm; p=0.752). CRM involvement rates were 7.6% in both groups (p=1.000). The DRM was not significantly different: 1.8±1.9cm versus 1.8±2.6cm; p=0.996. The quality of TME did not significantly differ: complete TME 87.3% vs. 83.7%; nearly complete TME 8.9% vs. 12.8%; incomplete TME 3.8% vs. 3.6%. Complications and clinical outcomes did not significantly differ.

Conclusion

This study did not find evidence to support that increased VFA would result in suboptimal histopathology specimen metrics when performing rTME in males with distal rectal cancer.

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Acknowledgments

** RESURRECT study group:

1) Seon-Hahn Kim, Colorectal Division, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea

2) Guglielmo Niccolo Piozzi, Colorectal Division, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea

3) Rosa Jimenez-Rodriguez, Section of Colorectal Surgery, Hospital Universitario Virgen del Rocio, Sevilla, Spain

4) Li-Jen Kuo, Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan

5) Tomohiro Yamaguchi, Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan

6) Fabio Cianchi, Department of Surgery and Translational Medicine, Careggi Hospital, University of Florence, Florence, Italy

7) Oktar Asoglu, Bosphorus Clinical Research Academy, Istanbul, Turkey

8) Vusal Aliyev, Department of General Surgery, Istanbul Florence Nightingale Hospital, Istanbul, Turkey

9) Dejan Ignjatovic, Surgical Department, Akershus University Hospital, Lørenskog, Norway

10) Yosef Nasseri, Cedar Sinai Medical Center, Los Angeles, CA, USA

11) Moshe Barnajian, Cedar Sinai Medical Center, Los Angeles, CA, USA

12) Dorin E. Popa, Linköping University Hospital, Linköping, Sweden

Funding

None.

Author information

Authors and Affiliations

  1. Section of Colorectal Surgery, Department of Surgery, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA

    M Gachabayov, DM Felsenreich, S Bhatti & R Bergamaschi

  2. Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria

    DM Felsenreich

Authors
  1. M Gachabayov
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  2. DM Felsenreich
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  3. S Bhatti
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  4. R Bergamaschi
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Consortia

on behalf of RESURRECT Study Group

  • Seon-Hahn Kim
  • , Guglielmo Niccolo Piozzi
  • , Rosa Jimenez-Rodriguez
  • , Li-Jen Kuo
  • , Tomohiro Yamaguchi
  • , Fabio Cianchi
  • , Oktar Asoglu
  • , Vusal Aliyev
  • , Dejan Ignjatovic
  • , Yosef Nasseri
  • , Moshe Barnajian
  •  & Dorin E. Popa

Contributions

Study conception and design: MG, RB. Acquisition of data: RB, RESURRECT Study Group. Analysis and interpretation of data: MG, DMF, SU, RB. Drafting of the manuscript: MG, DMF, SU, RB. Critical revision of manuscript: MG, DMF, SU, RB, RESURRECT Study Group.

Corresponding author

Correspondence to R Bergamaschi.

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Gachabayov, M., Felsenreich, D., Bhatti, S. et al. Does the visceral fat area impact the histopathology specimen metrics after total mesorectal excision for distal rectal cancer?. Langenbecks Arch Surg 408, 257 (2023). https://doi.org/10.1007/s00423-023-02981-7

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  • DOI: https://doi.org/10.1007/s00423-023-02981-7

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