title: Advantages of robot-assisted laparoscopic radical prostatectomy in obese patients: comparison with the open procedure.
abstract: OBJECTIVE
  Obesity has been suggested as a risk factor for worse perioperative outcomes, especially in radical prostatectomy, in several studies. However, the impact of obesity on perioperative outcomes has not yet been well elucidated for robot-assisted laparoscopic radical prostatectomy (RALP). We evaluated whether obesity had an adverse effect on outcomes following RALP compared with retropubic radical prostatectomy (RRP).
  
  
  METHODS
  From April 2008 to May 2011, 181 patients underwent radical prostatectomy (RALP, 111; RRP, 70). These patients were subdivided into two groups according to body mass index (BMI): the nonobese group (BMI, 25 kg/m(2) or less) and the obese group (BMI, greater than 25 kg/m(2)). Perioperative outcomes in RALP and RRP were retrospectively compared between the two groups.
  
  
  RESULTS
  In RRP, patients in the obese group (n=20) showed greater blood loss and a higher complication rate than did those in the nonobese group (n=50). However, in RALP, no statistically significant differences in perioperative outcomes were observed between the obese (n=37) and the nonobese (n=74) groups. RALP showed less blood loss and a lower complication rate in both the obese and nonobese groups than did RRP.
  
  
  CONCLUSIONS
  RALP is thought to be a more effective and safer procedure in obese patients compared with traditional open radical prostatectomy. In the management of obese patients with localized prostate cancer, RALP should be considered as a primary choice for treatment.
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Bae
authors.forename: Seock Hwan
authors.initials: SH
authors.lastname: Choi
authors.forename: Seok Hwan
authors.initials: SH
authors.lastname: Choi
authors.forename: Tae Gyun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim