The Effect of Obesity on Operating Room Utilization in Breast Surgery

Tata, Nalini; Byskosh, Alexandria; Helenowski, Irene; Dunderdale, Julie; Jovanovic, Borko; Kulkarni, Swati

doi:10.1016/j.jss.2020.10.012

Cited by 2 publications

(2 citation statements)

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“…Obese patients tended to have longer Total Operating Room Times (TORT) and Surgical Operating Room Times (SORT), with no decrease in surgical efficacy 25–27 . This finding has been particularly well documented and should be taken into consideration when scheduling breast procedures 28,29 . Increased operative time may be due to general factors such as positioning, induction, and intubation, or technical challenges during surgery, such as more tissue to dissect and suture.…”

Section: Discussionmentioning

confidence: 88%

“…[25][26][27] This finding has been particularly well documented and should be taken into consideration when scheduling breast procedures. 28,29 Increased operative time may be due to general factors such as positioning, induction, and intubation, or technical challenges during surgery, such as more tissue to dissect and suture. This has significant financial implications, as average operating costs have increased from $20/min in 1991 to $46/min in 2022.…”

Section: Discussionmentioning

confidence: 99%

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The impact of body mass index on oncoplastic breast surgery: A multicenter analysis

De La Cruz Ku,

Camarlinghi,

Mallouh

et al. 2023

Journal of Surgical Oncology

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BackgroundObesity has nearly tripled in the last 50 years. During the last decades, oncoplastic breast surgery has become an important choice in the surgical treatment of breast cancer. An association exists between higher body mass index (BMI) and wound complications for major operations, but there is scarce literature on oncoplastic surgery. Hence, our aim was to compare the complication rates among patients who underwent oncoplastic surgery, stratified by BMI.MethodsPatient data were analyzed from the National Surgical Quality Improvement Program database (NSQIP) for oncoplastic breast procedures (2005–2020). Patients were stratified according to World Health Organization obesity classifications. Multivariate logistic regression was performed to assess risk factors for complications (overall, operative, and wound‐related).ResultsFrom a total of 6887 patients who underwent oncoplastic surgery, 4229 patients were nonobese, 1380 had Class 1 obesity (BMI: 30 to <35 kg/m2), 737 Class 2 obesity (BMI: 35 to <40 kg/m2), and 541 Class 3 obesity (BMI: ≥ 40 kg/m2). Greater operative time was found according to higher BMI (p < 0.001). Multivariate analysis adjusted for baseline characteristics showed that patients with obesity Class 2 (odds ratio [OR] = 1.51, 95% confidence interval [CI]: 1.03–2.23, p = 0.037) and 3 (OR = 1.87, 95% CI 1.24–2.83, p = 0.003) had increased risk of overall and wound complications compared with Nonobese patients. Comparing obese with nonobese patients, there were no differences in rates of deep SSI, organ/space SSI, pneumonia, reintubation, pulmonary embolism, deep vein thrombosis, urinary tract infection, stroke, bleeding, postoperative sepsis, length of stay, and readmission.ConclusionsOncoplastic surgery is a safe procedure for most patients. However, caution should be exercised when performing oncoplastic surgery for patients with Class 2 or 3 obesity (BMI ≥ 35 kg/m2), given there was a higher rate of overall and wound‐specific complications, compared with patients who were not obese or had Class 1 obesity.

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Section: Discussionmentioning

confidence: 88%