Impact of body mass index on perioperative outcomes of laparoscopic radical nephrectomy in Japanese patients with clinically localized renal cell carcinoma

Abstract

Objective: The aim of this study was to review the association between body mass index (BMI) and perioperative outcomes of laparoscopic radical nephrectomy (LRN) in Japanese patients with renal cell carcinoma (RCC). Methods: This study included 108 consecutive Japanese patients undergoing LRN for RCC between April 2001 and March 2009. These patients were divided into the following two groups according to BMI: the non-obese group (n = 58, BMI 25 kg/m 2 or less) and the obese group (n = 50, BMI greater than 25 kg/m 2 ). Perioperative outcomes between these two groups were retrospectively compared. Results: There were no significant differences in clinicopathological parameters other than BMI between the non-obese and obese groups. There were no significant differences in operative time, estimated blood loss during LRN, and the incidences of open conversion and postoperative complications between these two groups. In addition, there were no significant differences in parameters related to postoperative recovery, including time to walk, time to oral intake and time until permission for discharge, between these two groups. However, significant trends toward a prolonged operative time (P = 0.0050) and increased blood loss (P = 0.012) during LRN in relation to BMI were documented by linear regression analyses. Conclusions: Although the degree of obesity in patients included in this study was comparatively slight, these findings suggest that LRN can be safely performed for patients with RCC irrespective of BMI. However, the difficulty of LRN may increase with BMI considering the trends toward longer operative time as well as greater blood loss.

Association Between Various Indices of Obesity and Intraoperative Factors in Laparoscopic Donor Nephrectomy

“…Although many reports have addressed the issues regarding the association between obesity and intraoperative factors, the results are still controversial. [11][12][13][14][15][16][17] One of the reasons for the different results may be the use of the BMI as an index for adult obesity, which does not always reflect body fat mass. Ode et al 18 reported that there are certain body types, such as patients with increased muscle mass, in whom BMI is poorly predictive of percentage body fat.…”

“…[8][9][10] Several studies have reported a correlation between operating time or blood loss and BMI in laparoscopic nephrectomy. [11][12][13] Transperitoneal laparoscopic renal surgery for obese patients with a BMI of 30 kg/m 2 or greater had longer operative times and increased blood loss compared with the same procedure in non-obese patients. 14 Similarly, laparoscopic nephrectomy for obese donors with a BMI in the range of 35.2-53.9 kg/m 2 had a longer operating time than that in non-obese donors with a BMI in the range of 18.4-29.0 kg/m 2 .…”

Obesity is a Risk Factor for Renal Toxicity and Wound Complications among a Cohort of Pediatric Cancer Patients at a Single Tertiary Care Institution

“…Additional reports for patients undergoing surgical resection of pancreatic and hepatic malignancies have also shown increased rates of wound infection or intraabdominal abscess in obese patients [14,36]. However, others report that despite the increased technical difficulty, longer operative times, and increase in intraoperative blood loss, obesity does not portend a higher rate of postoperative wound complications [5,34,37].…”

“…Of particular concern are recent reports estimating that approximately 4-7% of the of the affected pediatric population has a body mass index (BMI) percentile greater than 99 [2]. While long-term obesity-related health concerns such as type 2 diabetes mellitus and cardiovascular disease are wellestablished [3][4][5], recent literature has highlighted the increased risk for the occurrence of certain malignancies, including those arising from the gastrointestinal tract, kidney, breast, and endometrium, among obese adults [6][7][8][9][10]. In addition to increasing reports highlighting the apparent link(s) between chronic obesity and the development of cancer, numerous investigations have reported an increased incidence of documented treatment-related morbidity following the associated surgical and medical management of malignancies among obese adults when compared to individuals with a lean body habitus [11][12][13][14][15][16][17].…”

Obesity Is an Adverse Factor on Laparoscopic Radical Nephrectomy for T2 but Not T1 Renal Cell Carcinoma

“…Doublet and Belair also found no significant difference in operative time or complications between obese and nonobese patients [21]. Miyake et al reported no significant differences in operative time, estimated blood loss during LRN, and the incidences of open conversion and postoperative complications between these two groups [22]. In an analysis of 26 open radical nephrectomies and 30 LRNs, Lee et al reported that LRN is effective for both obese and nonobese patients [15].…”