Australasian Decrease in IntraPelvic Obesity for Surgery trial: Efficacy of a very low energy diet (VLED) to reduce weight and improve outcomes in obese patients undertaking laparoscopic rectal cancer surgery

Interventions: The VLED will be using the Optifast product which is an oral, nutritionally complete, very low calorie diet and limits energy intake to less than 800 calories per day.This involves the use of soups and shakes plus low starch vegetables, calorie free fluids and calorie free lollies and mints in small amounts.The duration is 4-6 weeks prior to surgery.The patients will keep a food diary to monitor adherence..
Primary outcome(s): Composite score of surgical factors that are indicative of a standard enhanced recovery following non restorative and restorative proctectomy for rectal cancer.
The composite surgical score of quality will include: Haemaglobin drop of greater than 20g/l and no transfusion, conversion, Anastomotic Leaks or pelvic sepsis, wound complications, 1.No other” complications (including DVT/PE, cardiac or respiratory complications), ambulation by day 2, tolerating normal diet by day 4, and discharge by day 7. A score out of 8 will be assigned without weighting.
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Study Design: Purpose: Treatment; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Safety/efficacy