Is obesity a factor of surgical difficulty in transanal endoscopic surgery?

Background: The aim of this study is to assess the feasibility of transanal endoscopic surgery (TES) in obese patients. Methods: Observational descriptive study evaluating the feasibility of TES in obese rectal tumors between June 2004 and January 2019. Patients were assigned to two groups: body mass index (BMI) < 30 kg/m² and BMI ≥30 kg/m², the latter defined as obese. Results: From 775 patients, 681 were enrolled in the study, 145 (21.3%) of them obese. No statistically significant differences between groups were found with respect to overall morbidity (27, 18.6%).The obese patients presented trends towards shorter mean surgical time (65 min, IQR 48 min), less perforation in the peritoneal cavity (eight, 5.5%), and 133 (91.7%) presented a lower rate of lesion fragmentation. Conclusion: There were no significant differences in postoperative outcomes in obese patients (BMI ≥30 kg/m²). TES in those obese patients does not represent a factor of surgical difficulty.