title: Does body mass index impact the performance of robot-assisted intracorporeal ileal conduit?
abstract: OBJECTIVE
  Body mass index (BMI) has been shown to influence perioperative outcomes for patients undergoing open radical cystectomy and urinary diversion. The impact of BMI on robot-assisted intracorporeal ileal conduit has not been studied.
  
  
  METHODS
  All patients undergoing robot-assisted radical cystectomy (RARC) with ileal conduit at our institution were offered intracorporeal ileal conduit beginning May 2009. Fifty-six consecutive patients underwent robot-assisted radical cystectomy with intracorporeal ileal conduit from May of 2009 to July 2010. Patients were categorized into three groups based on BMI: Normal (BMI < 25 kg/m(2)), overweight (BMI=25-29 kg/m(2)), and obese (BMI ≥ 30 kg/m(2)). The effect of BMI on intraoperative and postoperative outcomes was assessed by retrospective review of a comprehensive RARC quality assurance database.
  
  
  RESULTS
  Median age at cystectomy was 72 (range 42-87 y), and 75% of patients were male. Median follow-up for the entire cohort was 5 months (range 12 d-16 mos). Median BMI was 27 kg/m(2) (range 19-47 kg/m(2)), and 75% of patients were overweight or obese. Age, ASA score, and overall operative time were not significantly different among the normal, overweight, and obese patients. Median urinary diversion times were 95, 151, and 124 minutes for normal, overweight, and obese patients, respectively (P=0.13).
  
  
  CONCLUSIONS
  Robot-assisted intracorporeal ileal conduit can be safely performed in all body mass indices. Further studies are needed to assess long-term conduit function and stomal complications.
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA. Michael.Poch@RoswellPark.org
authors.forename: Michael A
authors.initials: MA
authors.lastname: Poch
authors.forename: Andrew
authors.initials: A
authors.lastname: Stegemann
authors.forename: Rameela
authors.initials: R
authors.lastname: Chandrasekhar
authors.forename: Mathew
authors.initials: M
authors.lastname: Hayn
authors.forename: Gregory
authors.initials: G
authors.lastname: Wilding
authors.forename: Khurshid A
authors.initials: KA
authors.lastname: Guru
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015653:Cystectomy; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012371:Robotics / Q000379:methods*; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*