title: Robot-assisted partial nephrectomy in obese patients.
abstract: OBJECTIVE
  To report our experience with robot-assisted partial nephrectomy (RAPN) in obese patients compared with a contemporary cohort of nonobese patients.
  
  
  METHODS
  We defined obesity as a body mass index (BMI) ≥ 30 kg/m(2). From June 2004 to September 2009, 97 patients underwent RAPN at our institution, of whom 49 were obese (group 1) and 48 were nonobese (group 2, BMI <30 kg/m(2)). We compared demographics, operative data, complications, and pathological outcomes between these two groups.
  
  
  RESULTS
  The average BMI for the obese group was 36.2 kg/m(2) (range 30.3-49) compared with 25.7 kg/m(2) (range 20.5-29.7) for the nonobese group. Median tumor size was 2.5 versus 2.3 cm for obese and nonobese groups, respectively. Obese patients had a larger median estimated blood loss (150 vs.100 mL, p=0.027) and a trend toward a longer median operative time (265 vs. 242.5 minutes, p=0.085) and median warm ischemia time (26.5 vs. 22.5 minutes, p=0.074), but this did not achieve statistical significance. An intraoperative complication occurred in one patient in each group. The postoperative complication rate was not statistically significant between the two groups (8.3% vs. 4.3%, p=0.377). The median hospital stay was 2 days for both groups.
  
  
  CONCLUSIONS
  RAPN is safe and feasible in obese patients. Obese patients had a higher estimated blood loss and a trend toward greater operative time and warm ischemia time, which did not achieve statistical significance.
authors.affiliation: Henry Ford Hospital, Vattikuti Urology Institute, Detroit, Michigan 48202, USA.
authors.forename: Naveed
authors.initials: N
authors.lastname: Naeem
authors.forename: Firas
authors.initials: F
authors.lastname: Petros
authors.forename: Shyam
authors.initials: S
authors.lastname: Sukumar
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
authors.forename: Akshay
authors.initials: A
authors.lastname: Bhandari
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kaul
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
authors.forename: Craig
authors.initials: C
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D009765:Obesity / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D012371:Robotics / Q000379:methods*