TY - JOUR
T1 - Perioperative Outcomes of Laparoscopic Partial Nephrectomy Stratified by Body Mass Index
AU - George, Arvin K.
AU - Rothwax, Jason T.
AU - Herati, Amin S.
AU - Srinivasan, Arun K.
AU - Rais-Bahrami, Soroush
AU - Shah, Paras
AU - Waingankar, Nikhil
AU - Saluja, Sandeep S.
AU - Richstone, Lee
AU - Kavoussi, Louis R.
N1 - Publisher Copyright:
© Copyright 2015, Mary Ann Liebert, Inc.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Background and Purpose: Increased body mass index (BMI) has been shown to have inferior perioperative outcomes in patients undergoing laparoscopic partial nephrectomy (LPN). The aim of this study was to determine the differences in perioperative outcomes for patients undergoing LPN in normal, overweight, and obese persons using established BMI risk categories. Methods: A retrospective review of 488 patients undergoing LPN was performed stratifying patients according to BMI of <25 kg/m2, 25 to 30 kg/m2, and >30 kg/m2. The analysis of variance test, chi-square analysis, and bivariate regression models were used to compare comorbidities and perioperative outcomes among the groups. Results: One hundred and eighty nine of 369 patients were identified as being obese. Obese patients were found to have a significantly higher American Society of Anesthesiologists class (2.4 vs 2.1) than normal weight patients (P=0.03). No significant differences were demonstrated in estimated blood loss, operative time, transfusion requirement, or rate of conversion between the groups. In addition, there was no significant difference in cardiovascular, pulmonary, thromboembolic, or infectious complications between the groups. Obesity was significantly associated with bleeding necessitating angioembolization (P=0.033). Conclusion: LPN demonstrates equivalent perioperative outcomes in normal, overweight, and obese patients. The minimally invasive approach achieves equivalent outcomes in patients undergoing major abdominal surgery although further studies of alternate procedures are needed to validate our findings.
AB - Background and Purpose: Increased body mass index (BMI) has been shown to have inferior perioperative outcomes in patients undergoing laparoscopic partial nephrectomy (LPN). The aim of this study was to determine the differences in perioperative outcomes for patients undergoing LPN in normal, overweight, and obese persons using established BMI risk categories. Methods: A retrospective review of 488 patients undergoing LPN was performed stratifying patients according to BMI of <25 kg/m2, 25 to 30 kg/m2, and >30 kg/m2. The analysis of variance test, chi-square analysis, and bivariate regression models were used to compare comorbidities and perioperative outcomes among the groups. Results: One hundred and eighty nine of 369 patients were identified as being obese. Obese patients were found to have a significantly higher American Society of Anesthesiologists class (2.4 vs 2.1) than normal weight patients (P=0.03). No significant differences were demonstrated in estimated blood loss, operative time, transfusion requirement, or rate of conversion between the groups. In addition, there was no significant difference in cardiovascular, pulmonary, thromboembolic, or infectious complications between the groups. Obesity was significantly associated with bleeding necessitating angioembolization (P=0.033). Conclusion: LPN demonstrates equivalent perioperative outcomes in normal, overweight, and obese patients. The minimally invasive approach achieves equivalent outcomes in patients undergoing major abdominal surgery although further studies of alternate procedures are needed to validate our findings.
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U2 - 10.1089/end.2014.0725
DO - 10.1089/end.2014.0725
M3 - Article
C2 - 25790190
AN - SCOPUS:84941120758
SN - 0892-7790
VL - 29
SP - 1011
EP - 1017
JO - Journal of Endourology
JF - Journal of Endourology
IS - 9
ER -