Yonsei Med J.  2015 Mar;56(2):382-387. 10.3349/ymj.2015.56.2.382.

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

• Komninos C
• Tuliao P
• Koo KC
• Chang CH
• Han WK
• Rha KH

• KMID: 2070014
• DOI: http://doi.org/10.3349/ymj.2015.56.2.382

Abstract

PURPOSE
To 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 METHODS
Data 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 (> or =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.
RESULTS
Tumor'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.
CONCLUSION
Our 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.

Keyword

Body mass index; partial nephrectomy; robotic surgery

MeSH Terms

Adult
Blood Transfusion
Body Mass Index
Female
Humans
Kidney Neoplasms/*surgery
*Laparoscopy/adverse effects
Male
Middle Aged
Nephrectomy/*methods
Obesity/*complications
Operative Time
Outcome Assessment (Health Care)
Postoperative Complications
Republic of Korea
Retrospective Studies
Robotic Surgical Procedures/*methods
*Robotics
Treatment Outcome
Warm Ischemia

Figure

• 

  Fig. 1 eGFR (mL/min/1.73 m2) trends during a period of 12 months after R-LESS PN in patients with normal BMI and high BMI, respectively. eGFR, estimated glomerular filtration rate (mL/min/1.73 m2); BMI, body mass index; R-LESS, robotic laparoendoscopic single-site surgery; PN, partial nephrectomy.

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