Perioperative Outcomes of Laparoscopic Partial Nephrectomy Stratified by Body Mass Index.

Academic Article

Abstract

  • 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/m(2), 25 to 30 kg/m(2), and >30 kg/m(2). 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.
  • Keywords

  • Adult, Aged, Aged, 80 and over, Body Mass Index, Body Weight, Comorbidity, Female, Humans, Kidney Neoplasms, Laparoscopy, Male, Middle Aged, Models, Statistical, Nephrectomy, Obesity, Operative Time, Overweight, Regression Analysis, Retrospective Studies, Treatment Outcome
  • Digital Object Identifier (doi)

    Author List

  • George AK; Rothwax JT; Herati AS; Srinivasan AK; Rais-Bahrami S; Shah P; Waingankar N; Saluja SS; Richstone L; Kavoussi LR
  • Start Page

  • 1011
  • End Page

  • 1017
  • Volume

  • 29
  • Issue

  • 9