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DIFFERENCES IN COMPLICATIONS AND OUTCOMES FOR OBESE PATIENTS UNDERGOING LAPAROSCOPIC RADICAL, PARTIAL OR SIMPLE NEPHRECTOMY

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 6 Part 1 Linguagem: Inglês

10.1097/01.ju.0000143820.56649.a4

1527-3792

Jason W. Anast, Marshall L. Stoller, Maxwell V. Meng, Viraj A. Master, Joseph A. Mitchell, William W. Bassett, Christopher J. Kane,

MRI in cancer diagnosis

No AccessJournal of UrologyAdult Urology: Urolithiasis/Endourology1 Dec 2004DIFFERENCES IN COMPLICATIONS AND OUTCOMES FOR OBESE PATIENTS UNDERGOING LAPAROSCOPIC RADICAL, PARTIAL OR SIMPLE NEPHRECTOMY JASON W. ANAST, MARSHALL L. STOLLER, MAXWELL V. MENG, VIRAJ A. MASTER, JOSEPH A. MITCHELL, WILLIAM W. BASSETT, and CHRISTOPHER J. KANE JASON W. ANASTJASON W. ANAST More articles by this author , MARSHALL L. STOLLERMARSHALL L. STOLLER More articles by this author , MAXWELL V. MENGMAXWELL V. MENG More articles by this author , VIRAJ A. MASTERVIRAJ A. MASTER More articles by this author , JOSEPH A. MITCHELLJOSEPH A. MITCHELL More articles by this author , WILLIAM W. BASSETTWILLIAM W. BASSETT More articles by this author , and CHRISTOPHER J. KANECHRISTOPHER J. KANE More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000143820.56649.a4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Obesity has increased dramatically in American society during the last 2 decades. While the laparoscopic approach is common for patients requiring radical and partial nephrectomy, it is unclear if this procedure leads to worse outcomes and complications in obese patients. We determined if obese patients undergoing laparoscopic radical (RN), partial (PN) and simple (SN) nephrectomy are at risk for worse surgical outcomes or increased complications. Materials and Methods: We retrospectively identified patients treated with nontransplant transperitoneal laparoscopic nephrectomies from 1998 to 2003. Patients with missing body mass index (BMI), operative, postoperative or pathological information were excluded from study. Obese patients (BMI 30 or greater) were compared to nonobese patients (BMI less than 30). Results: A total of 189 patients undergoing 117 RN, 44 PN and 30 SNs met study criteria, and 29.0% of patients were obese. Overall obese patients had longer operative times (280 versus 241 minutes, p = 0.003), greater estimated surgical blood loss (230 versus 109 ml, p = 0.0001) and higher transfusion rates (6.8% versus 0.8%, p = 0.032) than nonobese patients. In subgroup analyses obese patients receiving RN and PN had longer operative times and increased blood loss. Obese and nonobese patients have similar open conversion rates, analgesic requirements, hospital stay, time to oral intake, and major and minor complication rates regardless of nephrectomy type. Conclusions: Laparoscopic nephrectomy is associated with slightly greater operative time, estimated blood loss and transfusion rates in obese patients. Laparoscopic RN, PN and SN are safe and well tolerated in obese patients. 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Link, Google Scholar From the Department of Urology, Veteran's Affairs Medical Center (JWA, MVM, VAM, JAM, WWB, CJK), Department of Urology, University of California San Francisco (JWA, MLS, MVM, VAM, JAM, WWB, CJK) and The University of California San Francisco Comprehensive Cancer Center (MVM, VAM, CJK), San Francisco, California© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byGabr A, Elsayed E, Gdor Y, Roberts W and Wolf J (2008) Obesity and Morbid Obesity are Associated With a Greater Conversion Rate to Open Surgery for Standard but Not Hand Assisted Laparoscopic Radical NephrectomyJournal of Urology, VOL. 180, NO. 6, (2357-2362), Online publication date: 1-Dec-2008.Feder M, Patel M, Melman A, Ghavamian R and Hoenig D (2008) Comparison of Open and Laparoscopic Nephrectomy in Obese and Nonobese Patients: Outcomes Stratified by Body Mass IndexJournal of Urology, VOL. 180, NO. 1, (79-83), Online publication date: 1-Jul-2008.Bensalah K, Raman J, Bagrodia A, Marvin A and Lotan Y (2008) Does Obesity Impact the Costs of Partial and Radical Nephrectomy?Journal of Urology, VOL. 179, NO. 5, (1714-1718), Online publication date: 1-May-2008. Volume 172Issue 6 Part 1December 2004Page: 2287-2291 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordscomplicationsoutcome assessmentlaparoscopyobesitynephrectomyMetricsAuthor Information JASON W. ANAST More articles by this author MARSHALL L. STOLLER More articles by this author MAXWELL V. MENG More articles by this author VIRAJ A. MASTER More articles by this author JOSEPH A. MITCHELL More articles by this author WILLIAM W. BASSETT More articles by this author CHRISTOPHER J. KANE More articles by this author Expand All Advertisement PDF downloadLoading ...