Panniculectomy in End-Stage Renal Disease

Bailey, Chad M.; Troppmann, Christoph; Kuo, Jennifer H.; Wong, Michael S.

doi:10.1097/sap.0000000000000424

Cited by 12 publications

(4 citation statements)

References 6 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Firstly, obesity may worsen outcomes due to the pro‐inflammatory nature of adipose tissue, which has been found to accelerate rejection pathways in lung grafts 27 . The cohort in this review demonstrated an exceptional graft survival greater than 98%, suggesting that panniculectomy performed in the obese ESRD population confers a negligible risk to graft survival 9,16,17 . Secondly, obesity, especially in BMI above 35 kg/m 2 , is largely associated with comorbid conditions that impact graft survival, including diabetes and hypertension 20 .…”

Section: Discussionmentioning

confidence: 93%

“…Three articles pertained to panniculectomy performed simultaneously to renal transplantation 13–15 . The remaining six studies focused on panniculectomy in ESRD patients prior to transplantation 8,9,16–19 . A total of 783 ESRD patients underwent panniculectomy among the studies identified.…”

Section: Resultsmentioning

confidence: 99%

“…27 The cohort in this review demonstrated an exceptional graft survival greater than 98%, suggesting that panniculectomy performed in the obese ESRD population confers a negligible risk to graft survival. 9,16,17 Secondly, obesity, especially in BMI above 35 kg/m 2 , is largely associated with comorbid conditions that impact graft survival, including diabetes and hypertension. 20 While panniculectomy may not directly impact the course of such conditions, reduction of overall adipose tissue has been associated with improvements in glycemic and lipid levels.…”

Section: Discussionmentioning

confidence: 99%

“…In eight articles, authors described performing the transverse technique, a single surgical incision is performed allowing for horizontal pannus dissection. 9,13,[15][16][17][18][19] One study also employed the Fleur-de-Lis technique in which both horizontal and vertical incisions are carried, increasing the possible amount of skin ressected. 14 Surgical drains were routinely placed in all but one study.…”

Section: Systematic Reviewmentioning

confidence: 99%

See 3 more Smart Citations

Safety and utility of panniculectomy in renal transplant candidates and end stage renal disease patients

Laspro,

Stead,

Barrow

et al. 2024

Clinical Transplantation

View full text Add to dashboard Cite

BackgroundAs the obesity crisis in the United States continues, some renal transplantation centers have liberalized their BMI criteria necessary for transplant eligibility. More individuals with larger body‐habitus related comorbidities with End‐Stage Renal Disease (ESRD) now qualify for renal transplantation (RT). Surgical modalities from other fields also interact with this patient population.MethodsIn order to assess surgical outcomes of panniculectomy in the context of renal transplantation and ESRD, the authors performed a systematic review following the Preferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA) 2020 guidelines. Due to a paucity of existing primary studies, we retrospectively collected data on patients with ESRD undergoing panniculectomy from the American College of Surgeons’ National Surgical Quality Improvement Program (NSQIP) to evaluate outcomes of body contouring in this patient population.ResultsFrom the systematic review, a total of 783 ESRD patients underwent panniculectomy among the studies identified. Of these, 91 patients underwent panniculectomy simultaneously to RT while 692 had their pannus resected prior to kidney transplant. The most common complication was hematoma followed by wound dehiscence. From the NSQIP database, 24 868 patients met the inclusion criteria for analysis. In the setting of renal transplant status, patients with diabetes, hypertension requiring medication, and requiring dialysis were more likely to suffer postoperative complications (OR 1.31, 1.15, and 2.2, respectively). However, upon sub‐analysis of specific types of complications, the only retained association was between diabetes and wound complication.ConclusionPreliminary data show that panniculectomy in ESRD patients appears to be safe, though with a nominal increased risk for complications. Pannus resection does not appear to impact post‐transplantation outcomes, including long‐term allograft survival. Larger, higher powered, randomized studies are needed to confirm the safety, utility, and medical benefit of panniculectomy in the context of renal transplantation.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%