title: Obesity is an adverse factor on laparoscopic radical nephrectomy for t2 but not t1 renal cell carcinoma.
abstract: OBJECTIVE
  Laparoscopic radical nephrectomy (LRN) is more challenging with increases in body mass index (BMI). Several recent studies have shown, however, that LRN can be safely performed even in obese patients. The influence of obesity on the perioperative outcomes of LRN has not been well elucidated for large renal tumors (>7 cm), however. We estimated the impact of obesity on LRN for stage T1 and T2 renal cell carcinoma (RCC).
  
  
  METHODS
  From January 2004 to March 2011, 266 patients underwent LRN (T1: 195, T2: 71). These patients were subdivided into the following two groups according to BMI: the nonobese group (BMI less than 25 kg/m(2)) and the obese group (BMI greater than 25 kg/m(2)). Perioperative outcomes were retrospectively compared between these two groups in T1 and T2 RCC patients.
  
  
  RESULTS
  There were no significant differences in perioperative outcomes between the obese and nonobese groups of T1 RCC patients. However, in T2 RCC patients, operative time and complication rate were significantly increased in the obese group.
  
  
  CONCLUSIONS
  Our results suggest that LRN can be safely performed in Korean patients with T1 RCC regardless of obesity. In T2 RCC patients, however, LRN may become more difficult with increasing BMI considering a longer operation time as well as a higher complication rate. We suggest that LRN for obese patients with T2 RCC be carefully considered.
authors.affiliation: Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Se Yun
authors.initials: SY
authors.lastname: Kwon
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Bae
authors.forename: Jung Gon
authors.initials: JG
authors.lastname: Lee
authors.forename: Seock Hwan
authors.initials: SH
authors.lastname: Choi
authors.forename: Bum Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Eun Sang
authors.initials: ES
authors.lastname: Yoo
authors.forename: Tae Gyun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim