Obesity Is Not Associated with Increased Operative Complications in Single-Site Robotic Partial Nephrectomy

Abstract

PurposeTo evaluate the impact of high body mass index (BMI) on outcomes following robotic laparoendoscopic single-site surgery (R-LESS) robotic-assisted laparoscopic partial nephrectomy (RPN).Materials and MethodsData from 83 Korean patients who had undergone robotic partial nephrectomy from 2006 to 2014 were retrospectively analyzed. The subjects were stratified into two groups according to WHO definitions for the Asian population, consisting of 56 normal range (BMI=18.5-24.99 kg/m2) and 27 obese (≥25 kg/m2) patients. Outcome measurements included Trifecta achievement and the perioperative and postoperative comparison between high and normal BMI series. The measurements were estimated and analyzed with SPSS version 17.ResultsTumor's complexity characteristics (R.E.N.A.L. score, tumor size) of both groups were similar. No significant differences existed between the two groups with regard to operative time (p=0.27), warm ischemia time (p=0.35) estimated blood loss (p=0.42), transfusion rate (p=0.48) renal function following up for 1 year, positive margins (p=0.24) and postoperative complication rate (p=0.34). Trifecta was achieved in 5 (18.5%) obese and 19 (33.9%) normal weight patients, respectively (p=0.14). In multivariable analysis, only tumor size was significantly correlated with the possibility of Trifecta accomplishment.ConclusionOur findings suggest that R-LESS RPN can be effectively and safely performed in patients with increased BMI, since Trifecta rate, and perioperative and postoperative outcomes are not significantly different in comparison to normal weight subjects.

The impact of body mass index on oncological and surgical outcomes of patients undergoing nephrectomy: a systematic review and meta‐analysis

“…Our results show no statistically significant difference in intraoperative complications between the BMI groups, and this finding is compatible with other studies [32–34]. Despite the common assumption of higher intraoperative blood loss and blood transfusion rates in obese patients [35], our study illustrated that blood transfusion requirements tended to be higher among patients with BMI <25 as compared to BMI >30 kg/m 2 .…”

The Impact of Obesity in Patients Undergoing Robotic Partial Nephrectomy

“…Several analyses have demonstrated that although obesity may pose unique intraoperative challenges, it does not necessarily lead to an increased complication rate in RPNs. In particular, Kiziloz and associates, 25 Komninos and colleagues, 26 and Abdullah and colleagues, 21 each of which encompassed several prior single institution studies, did not demonstrate an increased complication rate. These data suggest equivalent outcomes in terms of length of stay, complication rate, and positive margin rates.…”

Racial and Ethnic Disparities in Renal Cell Carcinoma: An Analysis of Clinical Characteristics

“…However, several studies have demonstrated the feasibility of performing nephron-sparing surgery or utilization of minimally invasive techniques in obese patients without any significant adverse outcomes when compared with non-obese patients. [24][25][26] Currently, criteria to decide whether a patient is a candidate for nephron-sparing surgery versus radical nephrectomy is based on tumor characteristics and not on BMI. The association between BMI and radical nephrectomy in this study probably reflects the academic setting of our institution where challenging cases are routinely referred.…”