title: Laparoscopic partial nephrectomy in obese and non-obese patients: comparison with open surgery.
abstract: OBJECTIVE
  The aim of this study was to compare the perioperative outcomes of open (OPN) and laparoscopic (LPN) partial nephrectomy in obese and non-obese patients.
  
  
  METHODS
  We analyzed records for a cohort of 56 patients (28 obese and 28 non-obese) who underwent OPN, as well as 112 (56 obese and 56 non-obese) who underwent LPN.
  
  
  RESULTS
  Obese patients undergoing OPN had increased operative time (285.9 +/- 69.7 versus 195.2 +/- 59.8 minutes), blood loss (484.5 +/- 272.1 versus 391.7 +/- 308.6 mL), clamp time (44.4 +/- 12.8 versus 28.2 +/- 10.5 minutes), intraoperative complications (14.3% versus 1.8%), postoperative complications (35.7% versus 17.9%), and hospital stay (6.4 +/- 2.8 versus 3.2 +/- 2.2 days) than those undergoing LPN. Comparison of obese versus non-obese patients who underwent LPN revealed similar perioperative outcomes, with the exception of a greater blood loss in the obese patient cohort (391.7 +/- 308.6 versus 280.9 +/- 202.1 mL). Finally, in comparing perioperative data among non-obese patients who underwent OPN versus LPN, those who underwent LPN were found to have improved operative times (248.9 +/- 45.0 versus 181.1 +/- 62.4 minutes), less blood loss (412.4 +/- 274.6 versus 280.9 +/- 202.1 mL), fewer intraoperative complications (21.4% versus 1.8%), and shorter length of hospital stay (6.3 +/- 2.8 versus 3.2 +/- 1.6 days).
  
  
  CONCLUSIONS
  Laparoscopic partial nephrectomy has significantly better perioperative outcomes than open partial nephrectomy in both the obese and non-obese populations.
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Frederico R
authors.initials: FR
authors.lastname: Romero
authors.forename: Soroush
authors.initials: S
authors.lastname: Rais-Bahrami
authors.forename: Michael
authors.initials: M
authors.lastname: Muntener
authors.forename: Fabio Augusto R
authors.initials: FA
authors.lastname: Brito
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Jarrett
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009765:Obesity; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D016896:Treatment Outcome