Laparoscopic partial nephrectomy in obese patients.
OBJECTIVE
To report our experience with laparoscopic partial nephrectomy in obese (body mass index greater than 30 kg/m2) patients compared with a contemporary cohort of nonobese patients.


METHODS
From August 1999 to December 2004, 140 obese (group 1) and 238 nonobese (group 2) patients underwent laparoscopic partial nephrectomy at our institution. We compared the demographics, operative data, and perioperative complications of these two groups.


RESULTS
Group 1 had a significantly greater incidence of hypertension and diabetes. In groups 1 and 2, respectively, the mean estimated blood loss was 310 mL (range 50 to 1500) and 249 mL (range 50 to 2500), the mean operating time was 3.4 hours (range 2.5 to 6) and 3.4 hours (range 1.5 to 6), and the mean warm ischemia time was 31 minutes (range 15 to 51) and 32 minutes (range 12 to 60). Intraoperative complications occurred in 8 patients (5.7%) in group 1 and 20 (8%) in group 2 (P = 0.19), with a blood transfusion rate of 6% and 3%, respectively (P = 0.42). The postoperative complication rate was not significantly different between the two groups (13% versus 9%, P = 0.77). The mean hospital stay was 2.8 days (range 1 to 8) for group 1 and 3.5 days (range 1 to 32) for group 2. Retroperitoneal access was associated with a shorter operative time and hospital stay in both groups.


CONCLUSIONS
Laparoscopic partial nephrectomy was performed safely in obese patients, with a perioperative complication rate similar to that of nonobese patients. The retroperitoneal approach was associated with a shorter operative time and hospital stay in the obese and nonobese patients.
Colombo
Jose R
JR
Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Haber
Georges-Pascal
GP
Aron
Monish
M
Xu
Meng
M
Gill
Inderbir S
IS
D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D009765:Obesity / Q000150:complications*; D012307:Risk Factors