Impact of BMI on robotic rectal cancer surgery versus three-dimensional laparoscopic rectal cancer surgery: a retrospective study.

OBJECTIVE: To examine how Body Mass Index (BMI) impacts postoperative complications in robotic and 3D laparoscopic radical resection for colorectal cancer. METHODS: A retrospective analysis was performed on 476 Individuals undergoing robotic and 3D laparoscopic colorectal cancer surgery at a single center. According to BMI, the patients were categorized into four groups: < 18.5 kg/m2, 18.5-23.9 kg/m2, 24-27.9 kg/m2, and ≥ 28 kg/m2. The intraoperative and postoperative complication rates among the groups were compared. RESULTS: In the low BMI group (< 24 kg/m2), no statistically significant difference has been seen in postoperative complication for both robotic and 3D laparoscopic groups. Starting from BMI ≥ 24 kg/m2, the robotic group showed significantly lower rates of anastomotic leakage, wound infection, intestinal obstruction, urinary retention, autonomic dysfunction, and unplanned reoperation in comparison with the 3D laparoscopic group (P < 0.05). Multivariate logistic regression was also performed, revealing that for every 1 kg/m2 increase in BMI, the 3D laparoscopic group's complication risk increased by approximately 33%, while the robotic group's risk decreased significantly (P < 0.001). CONCLUSION: An increase in BMI, robotic surgery shows a clear advantage in reducing postoperative complications compared to 3D laparoscopic surgery, particularly for overweight and obese patients.