|Anastomotic leak is a major concern in obese patients because they may experience more intraoperative technical difficulties, comorbidities, and healing delays secondary to neoadjuvant chemoradiation (NCRT). However, the majority of studies included in this review that evaluated this concern in CRC or only rectal cancer did not report any significant differences between obese and non-obese patients. One study showed a higher leak rate in obese patients who did or did not undergo NCRT vs. non-obese patients (14 vs. 5, respectively; p=0.003). But this is related only to mid to lower rectal anastomoses and only 25 of 571 underwent laparoscopy. The authors discussed that the technical complexity expected in obese patients and the low tumor location explain the increased anastomotic leak rate
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