P1.172. Comparison of Intraoperative Complications in Obese vs Non-Obese in Oesophageal Cancer Surgery

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background Obesity is a substantial public health issue. A high body mass index (BMI) can increase surgical technical challenges, resulting in higher rates of intraoperative and postoperative complications. We aimed to assess whether intraoperative complication rates, using the the ClassIntra classification, differed between BMI categories in patients undergoing oesophageal cancer surgery. Methods Retrospective review was conducted of all oesophageal cancer resections at a single Australian site from 2013 to 2023. Patients were stratified into three BMI categories: “not obese” (<25), “overweight” (25-30), and “obese” (>30). Intraoperative complications were graded using ClassIntra. Secondary outcomes included operative time, blood transfusions, post-operative complications, length of stay, readmission, mortality, positive margins, and lymph node yield. Results 70 patients were included. 24 patients (34.3%) were “not obese”, 32 (45.7%) “overweight”, and 14 (20%) “obese”. There was no significant difference in ClassIntra complication rates across BMI groups (p=0.257 univariate, p=0.913 multivariate). Most patients experienced no intraoperative adverse events (71.4%). Obese patients had significantly longer operative times (7.1±1.5hours, p=0.026) though this did not correlate with increased complications. Overweight patients had higher 30-day readmission rates (21.9%, p=0.02), but other outcomes including length of stay, complication severity, mortality, and pathological factors such as margin positivity and lymph node yield did not differ significantly by BMI. Conclusion Our results suggest that obesity does not affect the rate of intraoperative complications in oesophagectomy cancer resection, nor significantly impact post-operative complications. Obese oesophagectomy patients require longer operative times. This may reflect increased technical difficulty due to obesity, without translating to significant adverse events. Overall, the data indicates that oesophagectomy cancer surgery can be performed safely regardless of BMI.