Impact of Obesity on Complications of Laparoscopic Simple or Radical Nephrectomy

Abstract

Objective: To determine the impact of obesity on complications in laparoscopic simple or radical nephrectomy. Patients and Methods: The medical files of 215 patients who underwent laparoscopic simple or radical nephrectomy in our center between 2004 and 2014 were reviewed. A body mass index of 30 kg/m² was used to divide the patients into obese and non-obese groups. Pre-operative data and intra- and post-operative complications were compared between the 2 groups. Results: There were respectively 163 and 52 patients in the non-obese and obese groups, which were comparable in terms of age, sex, and history of surgery. In the obese group, operative specimens were significantly heavier (772 vs. 534 g in the non-obese group; p = 0.005) and durations of surgery was significantly longer (244 vs. 216 minutes; p = 0.003). However no significant differences were found between the 2 groups for duration of hospitalization, surgical conversion, estimated blood loss, or intra- or post-operative complications. Conclusion: Laparoscopic simple or radical nephrectomy is technically feasible in obese patients but the surgery may take more time, notably due to dissection difficulties. Our results showed that the risk of intra- and post-operative complications is not higher in obese patients compared to non-obese patients, except for a possible, but statistically undemonstrated, higher risk of abdominal wall complications, and that the laparoscopic approach should be the preferred technique in patients with high body mass index.

Impact of Body Composition in Overweight and Obese Patients With Localised Renal Cell Carcinoma

“…In others studies, sarcopenia was not associated with postoperative complications in patients with upper-tract urothelial carcinoma and obesity who underwent radical nephroureterectomy (27). We suggest that BMI plays a more important role in postoperative complications than body composition (35,36). In conclusion, weight control might be necessary before surgery for patients with RCC, and more preventive measures for complications should be taken for the obese population compared to overweight patients.…”

Comparing the complications of laparoscopically performed simple, radical and donor nephrectomy

“…The fact that patients with significantly worse health characteristics were stratified to the LRN and partially to the LSN group may have led to selection bias which would render comparisons in this regard unfeasible. On the other hand, Arfi et al examined the effect of obesity on the results of LSN and LRN operations, and stated that obesity did not affect the incidence of complications, but increased the duration of the operation [32]. Another finding that may explain the increased frequency of complications in the LRN group is that the ASA scores, which measure preoperative physical health status, were significantly higher in the LRN group than the other 2 groups.…”

Living Kidney Donation, Obesity, and Dietary Change: Investing in Those Who Give the “Gift of Life”

“…Higher BMI has been associated with an increased risk of perioperative and postoperative complications such as surgical site infections, hernias, and deep vein thrombosis in different study populations. [34][35][36] Obesity is associated with prolonged duration of surgery and slower postoperative recovery. The risk of surgical complications has been shown to double with prolonged operative duration and increases by 14% for every 30 minutes of additional operating time.…”